Basketball Registration PDF Print E-mail

Please Print form and mail it to address listed on it

with enclosed check

  SSAP Basketball Registrations

(REGISTRATIONS ARE OPEN)

 

 SHOOT SOME HOOPS!!!

SSAP Girls and Boys Basketball

3-6 Grades

Recreational league where everyone plays!

Season will run from  late Dec-Feb or March

with the vast majority of games on Saturdays.

Travel will be involved.

Volunteer coaches and assistants are needed.

COST $45.00

 Childs Full Name: ________________________________________________

Home Address: __________________________________________________

Grade: ___________   School:_______________________________________

Skills

Years involved

Need More info

Yes

NO

comments:

Played Rec

Clinics

Player Jersey (free) 

         circle size

Youth:   M      L         Adults:   S        M L        XL

 

Please  VOLUNTEER!


COACH NAME:__________________________________________________________________          

CONTACT INFORMATION:________________________________________________________

 PARENT/GUARDIAN EMAIL:_____________________________________________

 PHONE: HOME_______________________CELL/WORK______________________

MEDICAL/PHYSICAL CONDITIONS A COACH SHOULD BE AWARE OF

___________________________________________________________________

VOLUNTEERS  !   NEEDED

With check enclosed

Please send too:

590 VINE ST

APT 1

                                                             SPRINGFIELD NE  68059

By state law, effective July 9, 1988, we must inform you that coaches, managers, referees, or anyone who prepares any playing court shall not be liable for the injury, death, or property damage of any participant in the Basketball program ran by SSAP and  which results from the negligence of any of the above listed individuals. Your signature appearing below on this registration form is your acknowledgement that you clearly understand the above statement and realize that this is a release of liability. Make yourself a copy of this form when completed by you.

 PARENT/GUARDIAN SIGNATURE:___________________________________________________DATE:____________________

Last Updated on Wednesday, October 29, 2014 at 12:24 pm