COMPETITIVE BASKETBALL LEAGUE
FALL Session 2011
3RD-7th Grade Boys & Girls
INDIVIDUAL REGISTRATION
Registration due: 10/31/11 Games start: 11/7/11 & 11/8/11
First Practice: 10/20/11 @ 6pm
Last Name:_______________________ First Name:_____________________
Child’s current grade ______________ Boy OR Girl ____________
Address ______________________City/State/Zip______________________________________
Email Address____________________________________ Cell Phone: (_____)____________________
Parent/Guardian Name ____________________________Home Phone: (_____)____________________
Medical Insurance Co.: ______________________________Policy No. :_________________________
Parental release: This is to certify that my son/daughter has permission to participate in any and all basketball activities. I assume all risks and hazards incidental to such participation, and I do hereby agree to hold harmless the staff of the All Star Sports Arena from any and all claims arising out of any injury to my child. Furthermore, this verifies that the player is up to date with his/her immunizations and is able to participate in all basketball activities. In the event of injury my permission is granted for treatment as required at the nearest medical treatment facility.
Medical Problems:_________________________________________________
Guardian's Signature:_____________________________________________________
* 2 Monday Games for the Girls & 2 Tuesday Games for the Boys *
(Pending availability)
*Individual registration players receive a weekly training session with our trainer*
*8 games guarantee*
$45.00
* An admission fee will be charged at all games*
TOTAL PAYMENT:______________________ DATE RECEIVED:______________________
IMPORTANT NOTE: Enrollment is limited. Full and final payment is due at the time of registration.
(Make check payable to “All Star Sports Arena”)
Send Registrations & Payment to: All Star Sports Arena
1906 Cambridge St / Springdale, AR 72764
Questions or Comments, or
For more information call: Tammy (479) 595-4385
