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application 2011 2012

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									             2/19/2012
                                  Boys & Girls Club of Tahlequah
                                Tahlequah Youth Basketball League
                               Deadline for Entry: Monday Dec 5, 2011
The Tahlequah Youth Basketball League (TYBL) is in its 20th year of organized basketball for the Tahlequah area
youth. The primary goals of the TYBL will remain as in the past years: participation, fun, learning fundamentals,
and teaching good sportsmanship. TYBL is separated into 4 divisions: 3rd & 4th grade boys, 3rd & 4th grade girls,
5th & 6th grade boys, 5th & 6th grade girls.


             All 3rd /4th, 5th /6th, grade participants must attend a combine.


                                           3rd & 4th Grade Girls, Monday Dec 5, 6:00PM
                                           3rd & 4th Grade Boys, Monday Dec 5, 6:30PM
                                           5th & 6th Grade Girls, Monday Dec 5, 7:00PM
                                           5th & 6th Grade Boys, Monday Dec 5, 7:30PM

                                           The combine will be held at the Boys & Girls Club Gym
  SMART MOVES-POWERHOUR                          The old Central Elementary Gym


The tryout/combine will allow us to evaluate the players’ level of basketball experience for draft. The draft will be
held the week of Dec 8th with practice starting the week of Dec 12, 2011. Games will start January 14, 2012 and run
through Feb 11, 2012 with a make up date scheduled for Feb 18, 2012. Games will be played primarily on
Saturdays.

Practices will only occur if school is in session. If the schools are closed for any reasons there will be no
practices.

REGISTRATION FORMS CAN BE PICKED UP AT FELT SHOES, OR ANY OF THE BOYS & GIRLS CLUBS

RETURN ALL FORMS TO THE BOYS & GIRLS CLUB ADMINISTRATIVE OFFICE STARTING NOV 28TH

ENDING DEC 5th AT THE COMBINE. THE ADMINISTRATIVE OFFICE IS LOCATED AT THE CORNER

OF CHEROKEE & MORGAN.

                   ONCE TEAMS ARE FULL NO OTHER PLAYERS WILL BE ACCEPTED

                              $35 MUST ACCOMPANY ALL FORMS RETURNED.


       ALL LATE SIGN-UPS MUST PAY $40 (Make checks payable to Boys & Girls Club of Tahlequah)


In order for this or any league to be successful, parents, and coaches must step forward and play a major role.
We are asking qualified parents or friends to help make it successful for our youth by volunteering to coach or
assist in other areas.

                               For more information contact: Dennis Kelley     931-1880
                   2/19/2012


                                                     Boys & Girls Club of Tahlequah
                                                   Tahlequah Youth Basketball League
                                                  Deadline for Entry: Monday Dec 5, 2011

       PLAYER INFORMATION                                                    PLEASE FILL FORM OUT COMPLETELY AND CLEARLY
Last Name: _____________________________________First Name: _____________________________________Boy                                                                Girl
                                                                                                                                                         (Circle one)

Grade: 3rd 4th 5th 6th , 7th, 8th                                                                      Shirt Size: YS_ YM YL AS AM AL AXL
                         (Circle)                                                                                                        (CIRCLE SIZE)
Birthday:                            Age        Ht.            Wt.             Name of School currently attending:                               __________________.
                                     (Height and weight must be filled in)

SIBLING PLAYING IN THE SAME AGE GROUP? YES/NO SIBLING NAME___________________________________

Mailing Address:                                                                          City:                              e-mail                                ______

Parent Home Phone                                                              Cell Phone____________________________________________________

Emergency contact: ____________________________________________phone:________________________________________


If you wish to coach or assist: Name:                                                                                Phone number home             ___Cell______________

THIS CONSENT AND RELEASE signed by: _____________________ _________and________________________________________
                                                   (Print Parent and/or Guardian)                (Print Parent and/or Guardian)
On behalf of _______________________________________As his/her parent or legal guardian is executed for the purpose of allowing
                       (Print Participant)
My child________________________ to participate on a little league basketball team being coached by coaches to be selected at a later
             (Print Participant)
date and other assistants that they may chose. In consideration of said coaches and their assistants working with the above named child, we
hereby agree as the above named child’s legal guardian and/or parent to pay for, defend, indemnity and hold said coaches, their agents,
employees, successors and assigns, and the Tahlequah Youth Basketball League/Boys & Girls Club of Tahlequah, its agents or employees
harmless from any and all liabilities, claims and demands for loss, damage or injuries to the above named child or his property.

I am aware that basketball is a contact sport and that the above named child will be required to perform strenuous, physical activity while
practicing or competing and that it is and could be hazardous to the above named child be irrespective of this knowledge, I assume all risks
of injury, loss and damage to the above named child or his property while at practice, traveling to and from competition, or while playing
in a game.

As a parent or guardian of the above named child, this agreement is made individually and on behalf of this minor child to induce the
Tahlequah Youth Basketball League / Boys & Girls Club of Tahlequah, and the local Tahlequah teams, to allow said child to participate in
little league basketball.

I HAVE READ THE ABOVE AGREEMENT FULLY AND COMPLETELY.

Dated this_________ day of_____________ , 2011.

_______________________________                                        ___________________________
Parent and/or Guardian’s Signature                                              Parent and/or Guardian’s Signature
                                                                                                                                  SMART MOVES-POWERHOUR

RETURN WITH $35 TO THE BOYS & GIRLS                                                                                                      Office Use Only
CLUB ADMINISTRATIVE OFFICE LOCATED                                                                                        Application is completely filled out
                                                                                                                           and signed,
AT THE CORNER OF CHEROKEE & MORGAN.                                                                                       Agreement filled out and signed.
                                                                                                                         If any of the above criteria is missing do not
                                                                                                                                     accept the application

								
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