Basketball Registration Form

CENTERVILLE YOUTH LEAGUE – BASKETBALL

Player's Name *

First

Last

Parent's Name *

Address *

Primary Phone Number *

Email *

May Text? *

Yes No

Players Grade *

Birthdate *

Player Shirt Size *

YXS YS YM YL

Volunteer to Coach? Please enter coach name *

Team Request *

***Please note, requests are only guaranteed for siblings

LIABILITY RELEASE I understand that by signing below I give permission for my child to participate in sports with Centerville Youth League. I understand there are significant risks involved with playing sports and that I hold Centerville Youth League, its board members, coaches, officials, and volunteers, harmless for any injury incurred by my child during the course of playing such sports, either during practice or games. I further understand that I release any claims of negligence, action, or inaction against CYL, its board members, coaches, officials, and volunteers. I understand that CYL does not provide any type of accident or health insurance to cover my child in case of injury. Further, I hereby authorize the CYL staff to administer basic first aid to my child in the absence of a parent or legal guardian. I also authorize CYL to consent to any emergency medical treatment which medical personnel deem advisable or necessary in the absence of a parent or legal guardian.

Parent Initials *

CONSESSION/VOLUNTEER DUTIES
I understand that by signing below I agree to participate in a minimum of two (2) concession shifts of at least two (2) hours during the current sports
season. By doing this, I understand that this will help keep registration costs low so that CYL is not required to hire outside, paid help. If I do not participate in at least two concession shifts during my child’s current sports season, I understand that I will be charged an additional $25 registration fee to register my child for the next sports season.

Parent Initials *

FUNDRAISER
CYL is a Not for Profit Organization ran completely by parent volunteers. It depends on those volunteers and fundraising activities to maintain and operate the grounds, facilities, and programs. I understand that by signing below, I have to option to either: (1) participate in the required fundraiser, or (2) pay the fundraiser buyout of $35.00.

I Choose: *

Fundraiser Buyout

By submitting your electronic signature below, I acknowledge and agree that I have read the above information and give permission for my child to participate in Centerville Youth League activities.

Parent Signature *

Submit