TRYOUT REGISTRATION | Erie Crossover Basketball

Participate Name *

First

Last

Date of Birth *

MM/DD/YYYY

Gender *

School *

Current Grade *

Check position you play *

Point Guard
Guard
Forward
Center

Address *

& Birth Gender

City *

State *

Zip

Parent/Guardian Name *

First

Last

Parent/Guardian Phone *

Parent/Guardian Email *

Permission & Agreement *

I agree and give my permission

As the parent or guardian of the child, whose name appears below, authorizes my child to participate in the Crossover Basketball Club Tryout. I agree to indemnify and hold harmless the Crossover Basketball Club Staff, its parent organization, and all of its employees and volunteers from and against any and all liability for injury or damages which may result from his/her participation in the above-mentioned league and the associated activities, such as photograph sessions, promos or any other associated activity to do with advertising this league. I also agree that, if efforts to contact myself or other emergency contacts fail, the coaching staff may act as best fits the situation, in case of an emergency. This is not a Local School District sponsored program and Local School District accepts no liability or responsibility for this program/activity.

Type Parent Signature *