Youth Basketball Registration

ROSE HILL BAPTIST CHURCH

1Player Information

First Name *

Last Name *

Date of Birth *

Age *

Shirt Size *

2Parent/Guardian Information

Parent/Guardian Name *

Relationship to Player *

Street Address *

City *

State *

ZIP Code *

Email Address *

Phone Number *

Emergency Contact Name *

Emergency Contact Phone Number *

3Medical Information

Please list allergies, medical conditions, medications (including dosage), and any relevant emergency or insurance information. Enter “None” if there is nothing to report.

Medical Information

4Terms and Conditions

Statement of Participation: I understand and agree to the rules and regulations of the Rose Hill Baptist Church Sports League.

Release of Liability: I acknowledge the risks of participation in youth athletics and agree to the church’s participation terms, subject to applicable law.

Photo/Video Permission: I authorize the church to use my child’s photograph or video for promotional purposes only if I select “Yes” below.

Photo/Video Permission *

I am the parent or legal guardian, and I have read and agree to the participation and liability statements above. *