Brunswick Winter League Registration
Brunswick Winter League Registration Name:______________________________________ Grade:______ (2016/2017) Address:_________________________ City:____________________ Home or Cell Number:_______________________ Email:____________________________________(confirmation purposes) Circle Girls or Boys and check appropriate league below:
Girls / Boys ____ 1st and 2nd ____ 3rd and 4th
____ 5th and 6th ____ 7th and 8th
T-Shirt Size: Please circle appropriate size Youth medium, large Adult: small, medium, large, xl Preferred Jersey # :__________________( list top three selections) If there is a player or coach you would like your son to be teamed with for various reasons, please write their name in the space below. We will do our best to honor your request but will not guarantee it will happen. Thanks! By my signature, I attest my son is able to participate in the program indicated. I have full knowledge of the risks involved. In consideration of acceptance of this registration, I waive and all rights and claims for damages we have against Brunswick Youth Basketball, Brunswick City Schools or the Brunswick Recreation Dept. and its staff and will hold them harmless for any and all injuries incurred. Parent/Guardian Signature: ______________________________________ Date: __________________ Mail registration and $65 check payable to Blue Devils Youth Basketball to: Joe Mackey 3581 Center Road Brunswick, OH 44212
Girls / Boys ____ 1st and 2nd ____ 3rd and 4th
____ 5th and 6th ____ 7th and 8th
T-Shirt Size: Please circle appropriate size Youth medium, large Adult: small, medium, large, xl Preferred Jersey # :__________________( list top three selections) If there is a player or coach you would like your son to be teamed with for various reasons, please write their name in the space below. We will do our best to honor your request but will not guarantee it will happen. Thanks! By my signature, I attest my son is able to participate in the program indicated. I have full knowledge of the risks involved. In consideration of acceptance of this registration, I waive and all rights and claims for damages we have against Brunswick Youth Basketball, Brunswick City Schools or the Brunswick Recreation Dept. and its staff and will hold them harmless for any and all injuries incurred. Parent/Guardian Signature: ______________________________________ Date: __________________ Mail registration and $65 check payable to Blue Devils Youth Basketball to: Joe Mackey 3581 Center Road Brunswick, OH 44212
