PLAYER INFORMATION

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Name *
E-mail Address *
Event Registering For: *	2011 Fullcourt Press Fall Showcase
Sign Up Date: 00/00/00 *
Participant's Name: *
Player e-Mail:
Phone Number *
Mobile Phone Number
Home Address *
City *
State *
Zip Code *
Grade 2011-12 *
School *
Height *
Weight *
Health Insurance Co. *
Policy Number *
Group Number
Parent/Guardian *
*** I have read and agree to the Event Rules & Regulations as outlined at the bottom of this page. *	Yes No

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*** EVENT RULES & REGULATIONS

I understand that any Fullcourt Press Fall Showcase participant who does not abide by the rules, regulations and policies established by the Fullcourt Press Fall Showcase (FPFS) is subject to dismissal without reimbursement or recourse and I hereby waive and release the FPFS and Dominguez High School (DHS) from any and all liability for any injury or illnesses while participating in the camp.  I hereby authorize the directors of the FPFS and DHS to act according to their best judgment in any emergency if I cannot be contacted.  I understand that each camp participant is required to have their own medical and accident insurance.  I also understand that the FPFS retains the rights to use for publicity and advertisements purposes, photographs of camp participants.

Any questions - call Dinos Trigonis at (562) 343-1473