Pine Forest UMC Basketball Registration Form
Name of player: ____________________________________________________________ Age: ______ Grade: __________DOB: ____________
Address: ________________________________________________________________________________ City _______Zipcode____________
Home Phone: ________________________ Cell Phone(s): ______________________________________________________________________
Work Phone: _______________________________ E-mail: _____________________________________________________________________
Parents’ Names: _______________________________________________________________________ Parent willing to coach: ___ Yes___ No
______________________________________________________________________Parent willing to volunteer: ___ Yes ___No
Emergency Contact Info (other than the parents):
Name: _________________________________________________________ Phone: ________________________________________________
Fees paid by: ___ Cash ___ Check No. ____________Payment received by: _______________________
Shirt Size (circle one): Y-Small 6-8 Y-Medium 10-12 Y-Large 14-16
A-Small A-Medium A-Large A-Xlarge A-XXlarge
EVERY PLAYER MUST FILL OUT THE LIABILITY RELEASE FORM
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Liability Release
I agree to hold Pine Forest United Methodist Church, its’ Trustees, Members, Employees, Pastors or any other tenet organization blameless for any injury or loss from injury incurred while participating in activities.
Parent/Registrar Signature: _________________________________________________
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Date: __________________
