Tuesday, September 5, 2017

Warren Elementary Basketball

Warren School District would like to invite your 1st, 2nd, 3rd, 4th, 5th and /or 6th grade child to participate in the Warren Elementary Basketball program. This league provides your child the opportunity to develop their basketball skills and understanding of team play while developing character and sportsmanship on and off the court.
Please complete this registration for each child that you have participating. The registration is FREE. The deadline to turn the form in is Friday September 22nd. 
We will have player evaluations on September 26th. If your child is planning on play they must attend player evaluations on the 26th. 1st and 2nd grade - 5:00 - 6:00, 3rd and 4th grade - 6:15 - 7:15, 5th and 6th grade 7:30 - 8:30. Teams will be announced on September 28th. 
Any questions you can contact me at jae.kell@warrensd.org or 501-351-1558


* Required
Name of Child

_______________________________

What Grade is your child in?
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade

My child is
Male
Female

Jersey top size
YS
YM
YL
AS
AM
AL
Parent Name *

____________________________

Parent phone number *

_______________________________

I would like to be
Head Coach
Assistant Coach
None

If you chose Assistant Coach, please put who you would like to coach with.

__________________________________

Name of parent wanting to coach

_____________________________

Best contact number

_______________________________

Does this child have any disabilities, present injuries, hemophilia, limitations, or any other significant medical conditions? *
Yes
No
If YES, please state condition

_____________________________________________________________
Doctors Name

_______________________________________

Doctors Contact

_________________________________________

Emergency Contact Name *

__________________________________________

Emergency Contact Number *

____________________________________________

Waiver of Liability and Disclaimer: I, the parent or guardian of the above named participant, acknowledge that participation in athletic events necessarily involves risk of physical injury. I further acknowledge that the programs of Warren School District Elementary Basketball are primarily administered by parents, who volunteer their time, rather than paid professionals. In consideration for accepting the registration of the above named individual and permitting the voluntary participation of said individual in its programs, I hereby release, discharge, and hold harmless Warren School District and it’s employees, volunteers, and other representatives from claims arising out of or relating to any physical injury that may result to listed individual while participating in the Warren School District Elementary basketball program. *

I AGREE
I DISAGREE


1 comment:

  1. Here is the link to fill out the form online.https://goo.gl/forms/IJTlSmCVX7Tu9OHM2

    ReplyDelete