Winter 2012 Basketball League Player Registration Form

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Winter 2012 Basketball League Player Registration Form Powered By Docstoc
					                                                                                                            WINTER 2012
                                        NORTH                                                               BASKETBALL                                                      NORTH
                   **** SEASON BEGINS January 14, 2012                                                  END-OF-SEASON TOURNAMENT on March 3rd & 4th, 2012 ****
               PARENTS' ORIENTATION MEETING - JANUARY 4, 2012, 7:00-8:00PM @ Summit Christian Center, 2575 Marshall Rd.
       COACHES' ORIENTATION MEETING - JANUARY 5, 2012, 7:00-8:00PM @ the George Gervin Health & Wellness Center, 6919 Sunbelt Dr. South
                                                                                         GAME AND TOURNAMENT LOCATIONS:
              CANYON RIDGE ELEMENTARY, LOPEZ MIDDLE SCHOOL, & THE GEORGE GERVIN HEALTH & WELLNESS FACILITY

                                  **** MANDATORY PLAYER EVALUATION FOR DIVISION PLACEMENT !!!!
                    More info and LEAGUE REGISTRATION at www.stoneoakathletics.com
        REGISTRATION FEE $125                                              AGE DIVISIONS                                    JERSEY SIZES                         STONE OAK ATHLETICS FAN T-SHIRTS $10 EACH
 *Includes Team Jersey and Tournament Fees                        6U       8U         10UA    10UB          YOUTH: Small Medium Large X-Large                    YOUTH: Small Medium Large X-Large
       REGISTRATION DEADLINE                                        12UA         12UB         14U            ADULT: Small Medium Large X-Large                   ADULT: Small Medium Large X-Large
               DECEMBER 30TH!                                     Girls & Boys Teams Welcome!!                          XX-Large                                                XX-Large
PLAYER'S FIRST NAME                                           PLAYER'S LAST NAME                            DATE OF BIRTH                            AGE AS OF 9/1/2011



   M           F      PLAYER'S HOME ADDRESS                                                                 CITY                                     STATE                                  ZIP CODE


SCHOOL PLAYER ATTENDS                                                                                       DISTRICT                                 CURRENT GRADE


FRIEND/COACH/TEAM YOUR PLAYER REQUESTS TO PLAY WITH:                                                                                                 YES                                    NO
                                                                                                                   ARE YOU INTERESTED IN COACHING?

                                                                                                     PARENT INFORMATION
FATHER'S NAME                                                                                                MOTHER'S NAME


ADDRESS                                                                                                     ADDRESS


CITY                                                          STATE             ZIP                         CITY                                                 STATE          ZIP


PRIMARY PHONE CONTACT:                                                                                      PRIMARY PHONE CONTACT:


ALTERNATE PHONE CONTACT:                                                                                    ALTERNATE PHONE CONTACT:


EMAIL ADDRESS:                                                                                              EMAIL ADDRESS:


                                 I,THE UNDERSIGNED, BEING A PARENT OR LEGAL GUARDIAN, GIVE MY PERMISSION FOR THE ABOVE NAMED CHILD TO
                                  PARTICIPATE IN THE STONE OAK ATHLETICS PROGRAM. I UNDERSTAND THAT STONE OAK ATHLETICS PROVIDES NO
                                     INSURANCE, AND I RELEASE STONE OAK ATHLETICS, ITS VOLUNTEERS, OFFICERS, AND ANY REPRESENTATIVES
                               FROM ANY AND ALL LIABILITY CONNECTED WITH THIS PROGRAM. I ALSO AGREE THAT ALL COACHES/TEAM MANAGERS
                                          ARE PARENT VOLUNTEERS. I AGREE TO FULLY ABIDE BY THE STONE OAK ATHLETICS CODE OF CONDUCT.
                                                                                                    FAMILY DAY/FUNDRAISING OPTIONAL.
                                    Photographic Release- I authorize Stone Oak Athletics to use photos of my child's participation in their sporting events
                                                                  for promotional purposes on the Stone Oak Athletics website and print materials.


          _______________________________________________________________________________________                                                    _____________________________________________


                                       PARENT/GUARDIAN SIGNATURE                                                                                                          DATE

                                                                                             CREDIT CARD PAYMENT (VISA or MASTERCARD ONLY)
                   Credit Card Number                                                                                                                        Amount             $

                                                                                                                                                           (incl. t-shirt, if ordered)

   Signature (As It Appears On Card)                                                                                                                    Card Exp. Date


Customer Billing Name On Card:                                                                                                                       City:
   Information
                      Address:                                                                                                                             State:                           Zip:


                    Payment by check should be made out/mailed to: Stone Oak Athletics 10221 Desert Sands, Ste. 103, San Antonio, TX 78216
                                           Questions? Contact Tony Warren @ (210)779-5506 or Heather Wiliams @ (210)219-8221
                                                                                         SPECIAL TEAM DISCOUNTS APPLY!

				
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