Whitemarsh Youth Boys Basketball League 2007 -2008

Player Registration Form

WYBL reserves the right to deny participation to anyone who has not registered by draft night.

PLEASE PRINT CLEARLY

Name: __________________________________________________________________

Birth Date: __________________________League Age: ____________ (age as of 9/1/06)

Address: _________________________________________________________________________

City/State/Zip: ____________________________________________________________________

E-Mail: __________________________________________________________________________

 Phone (home): __________________________________ (work/cell): _________________________

School: _____________________________________________________Grade: ___________

Did you play in Whitemarsh Youth Boys BB last year? _____(yes) _____(no)

Are you playing in other leagues or involved in other activities that may conflict with Whitemarsh schedules? Please list and indicate potential conflict dates (days).

____________________________________________________________________________________

_____________________________________________________________________________________

Please indicate any requests and/or health concerns we need to be aware of:

____________________________________________________________________________________

I understand that there is risk of personal injury in participating in this type of recreational activity. In signing this release, I give permission to my child to participate in all activities for this season. I assume all risks and hazards incidental to the activity and for the transportation to and from this activity. I, the undersigned, do herby release the Whitemarsh Youth Basketball league (WYBL), their boards, officers, employees, teams, coaches, other volunteers and referees, Whitemarsh Township, Colonial School District, Oak Lane School, Crefeld School, United Methodist Church and other organizations/entities where games, practices or scrimmages are held, as well as any organization that holds a tournament or travel team game my child may participate in ( all together the “Released Parties”) from any claims (including all medical expenses) arising from personal injury, no matter how caused, which may occur to my child during his/her participation in the WYBL program and/or tournament games. In addition, I hereby waive any claims (including all medical expenses), suits, actions, or causes against Released Parties for personal injury, no matter how caused, which my child has incurred, may incur or suffer, during his/her participation in Released Parties’ activities. I further agree to indemnify and hold forever harmless the Released Parties against all losses (including all medical expenses), including counsel fees and court costs, from any and all claims made against it by any party as a result of my child’s actions, negligent or intentional which may result in injury or loss to another participant, spectator or other person. I also agree that my child and I (including friends and family members) will abide by and be subject to the rules and regulations of the Released Parties, and will conduct ourselves accordingly. I further grant permission to any licensed physician or emergency personnel to perform or provide medical care or aid as they deem necessary that may occur during Released Parties activities. I also understand that in case of injury, I must be available to pick up my child and seek additional care if necessary.

Signature, Parent Guardian_________________________________ Date_________________

Cash: $ ______________________ Check Number: _________________________________

Please make checks payable to WYBL (Whitemarsh Youth Basketball League)