FORT ZUMWALT WEST GIRLS BASKETBALL

							                   JUNIOR BULLDOGS PROGRAM
                                        Registration Form

Student’s Name:_____________________________                 DOB:________             Height:_____

Grade in 2011-2012:____       School attending in 2011-2012:__________________

Current team:___________ Preferred Jersey #:__________________

Parent’s name:_____________________________ Phone #:________

Address (city & zip code):____________________________________________________

Emergency phone number:________                       Email address:________________

What are your primary sports or activities? Please list them in order of priority.


What is your past experience playing the game of basketball? List camps, leagues, teams, etc.


What position do you play (circle one)?       Guard          Forward         Center

PARENT INFORMATION
The JUNIOR BULLDOGS GIRLS BASKETBALL PROGRAM is forming teams for the upcoming
season. The JUNIOR BULLDOGS GIRLS BASKETBALL PROGRAM is not affiliated with the
Fort Zumwalt School District. The program is designed to help girls that may have an interest in
playing basketball at Fort Zumwalt South High School. Participation in the program does not
guarantee a spot on the high school team.

Currently there are coaches for one team at the 3rd-8th grade levels. More coaches are needed.
Junior Bulldogs would like to form at least two teams in each grade from 3rd-8th. Parent volunteers
for coaching are a necessity and will help us provide an opportunity for everyone.

All girls who will attend Fort Zumwalt South in the future are invited to participate in tryouts. Each
team will have 8-12 players. Some teams may play year round. The cost to participate will vary
depending on the number of games played. Fund raising opportunities will be available.

As a parent, I am willing to participate in the following areas:
       ____ Coach                      ____ Team representative for a Junior Bulldogs committee
       ____ Assistant Coach            ____ Team Parent

I understand the information mentioned above and hereby give permission for (daughter’s name)
_________________________ to participate in the Junior Bulldogs Program basketball tryouts. I
waive the Fort Zumwalt School District from any and all liabilities for personal injury that may
occur while participating in the tryouts.

Parent signature_________________________                                    Date__________