2010 Fullcourt Press Spring Showcase

 

PLAYER REGISTRATION FORM

(please print)

 

 Name__________________________ School _______________________

 

Home Address _________________________________________________

 

City ___________________________________ State ___ Zip Code _______

 

Phone (       ) ______________________ e-mail ______________________

 

Grade 2009-10 ________________ Height ___________ Weight _________

 

Parent/Guardian _______________________________________________

 

Please Mail $60.00 Check (Make Checks Payable to “Fullcourt Press”) and Completed Form to: Dinos Trigonis, 3122 Theresa Street #1, Long Beach CA  90814

 

HEALTH AND BEHAVIOR GUIDELINES AND WAIVER OF LIABILITY

 

HEALTH INSURANCE CO. ______________________________________________________

 

Policy No. _____________________________________ Group No. _____________________

 

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

 

____________________________________________________________________________________________________ 

 

                                                     SIGNATURE OF PARENT OR GUARDIAN

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