Registration for OYAA Travel Basketball Team Tryouts

REGISTRATION # ____________________ _______BOY ______GIRL

________4^th GRADE __________5^th GRADE ________6^th GRADE

School attending this year_______________________________________________________________

Player Name________________________________________________________________

Address_____________________________________________________________________

City/State/Zip_________________________________________________________________

Parents/Guardians Names______________________________________________________________

Home Phone # w/area code (________) __________________________________

Cell or work Phone # (_________)_____________________________________________________

Birth Date (Month/Day/Year)________________________________________________

Player height_____________________________ Player weight_______________________

Previous basketball experience? (Please detail below, i.e. camps, recreation or travel teams, etc.)

_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Does your child have any prior medical or health problems that should be disclosed? Yes or No. If yes, please explain. ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

The following Hold Harmless Agreement must be read and signed by parents or legal guardians prior to participation in the OYAA travel basketball tryouts.

The undersigned parent or guardian, in consideration of the acceptance of their child as a participant in the Olentangy Youth Athletic Association does hereby; 1) Agree to assume any and all risks and liabilities incidental to active participation in OYAA Basketball Programs by such child; 2) Agree to indemnity, defend, and hold OYAA Basketball, it’s trustees, staff, officers, coaches, and all volunteer workers harmless and against any claims, demand and liability for any injury (property damage and loss or damage to personal property); 3) Acknowledge and understand that no medical insurance is maintained by OYAA Basketball, such insurance being the sole responsibility of each participant; and 4) Agree that prior medical and health problems must be disclosed by them to OYAA Basketball prior to any child being assigned to a team.

Signature of Parent or Guardian________________________________________________________

Date Signed__________________________________________