NW AUSTIN - Summer Youth Rec Basketball League
NW AUSTIN - Summer Youth Rec Basketball League for Boys & Girls Steiner Ranch, Cedar Park, Four Points, Round Rock, & Georgetown
At Concordia University st
th
Neighborhood Sports: Basketball League for Boys & Girls in 1 - 8 Grade Co-Ed Boys & Girls Basketball: 1/2 grade, 3/4 grade, 5/6 grade, 7/8 grade Game Format: Full Court Basketball Game Location: Concordia University (FM 620) Season: Games played on Mondays / Tuesdays at 6pm, 7pm, 8pm, 9pm… 6 week season (5 games and playoffs) Schedule: June 13/14, 20/21, 27/28, July 11/12, 18/19 End of season tournament is July 25/26. Register on-line at WWW.NSPORTS.US or by Fax: 512-257-3524 Register by Mail – Mail to: Neighborhood Sports Program @ 2000 Windy Terrace, Suite 7B, Cedar Park, TX 78613
Regular registration ends May 12, 2016 or when League becomes full. Late fee after May 12 ($20) (if space is available) – No Refunds
Basketball League Registration Categories: Volunteer Head coaches child $120 Regular Player $140
Donation…Help kids play who can’t afford to pay (I am donating $________) Players Name:
Parents Name:
Basketball Experience (circle one): Emergency phone: Age:
Birth Date:
Home phone:
New player
Experienced Player
Address: Grade:
(Circle one)
Zip
School:
Email: (required) Only Head coach’s child gets a discount
Very Good Player
City
Male / female (circle one)
Cell phone:
Friend / coach request
Head Coach
Assistant Coach
Team Parent
Code of Conduct and Sportsmanship Policy _____ Parent Initials
I have read the Code of Conduct and Sportsmanship Policy as posted under “Forms” on the www.neighborhoodsports.us website and understand that any violations may result in disciplinary action that could include, but is not limited to the following: verbal warning by official, Neighborhood Sports Director; ejection from field/gym; parental game suspension, game forfeit; or season suspension with no refund of fees.
Parents/Legal Guardians Please sign and submit attached (page 2) Participant Authorization to use Name, Likeness and Voice along with the Parent Release/Waiver Parent/ Legal Guardian signature _______________________________________________ Date ______________ ($4.00 Processing fee will be charged for all Credit Card Payments)
Payment: Check # _____ Cash ___ Credit (V/MC) __ __ __ __ -__ __ __ __ -__ __ __ __ - __ __ __ __ Exp. Date __ __ Register by Fax / credit card: (512) 257-3524
For more Information call 512-918-3524
Neighborhood Sports, a program offered by “It’s More Than a Game”, is an exempt organization under Section 501c3 of the IRS code. “Approval of distribution of these materials is in no way an endorsement of such services, activities, and/or products by the Leander, Austin, or Round Rock Independent School Districts.”
Participant Authorization to use Name, Likeness and Voice In consideration for being allowed to participate in the Neighborhood Sports NFL Flag football games and other related events and activities (individually and collectively, ”The Event”), I hereby authorize, license, permit and grant to I.M.T.A.G. LLC and Neighborhood Sports, assigns, successors, sponsors, sponsoring agencies, advertisers, and owners or lessors of premises used in connection with the Event, and their respective officers, directors, partners, members, shareholders, employees, agents, independent contractors and representatives (collectively, the “Authorized Parties”), the right to use, reproduce, print, publish or disseminate in all manners and media now known or subsequently developed, in all social media, broadcast, promotion, advertising, information, press releases and press conferences or announcements for the Event or other Neighborhood Sports programs or events, my name, likeness and voice. I understand the Authorized Parties have no obligation to use my rights of publicity in any materials. I, for myself and on behalf of my heirs, assigns and next of kin, hereby release, indemnify and hold harmless the Authorized Parties with respect to any and all injury, loss or damage, arising out of this authorization, whether from the negligence of any or all of the Authorized Parties or otherwise (Including from the Authorized Parties’ use of my rights of publicity), to the fullest extent permitted by law. I HAVE READ THE ABOVE AUTHORIZATION, FULLY UNDERSTAND ITS TERMS AND UNDERSTAND THE RIGHTS THAT I HAVE GRANTED BY SIGNING BELOW. I SIGN THIS AUTHORIZATION FREELY AND VOLUNTARILY, WITHOUT ANY INDUECEMENT OR COERCION _____________________________________ Participant Name
______________________ Date of Birth
Parent Release/Waiver In return for my child (*Participant) being allowed to participate in the Neighborhood Sports program (Program), I release and agree not to sue It’s More Than a Game Inc., Neighborhood Sports, their employees, sub-contractors, volunteers, sponsors, and affiliates from all present and future claims that may be made by the Participant or me, my family, estate, heirs or assigns for property damage, personal injury or wrongful death arising as a result of the Participant’s participation in the Program and caused by the ordinary negligence of the parties listed above, wherever, whenever, or however the same may occur. I understand and agree that those listed above are not responsible for any injury or property damage arising out of the Program, even if cause by their ordinary negligence. I understand that participation in the Program involves certain risks, including, but not limited to, serious injury. I am voluntarily allowing Participant to participate in the Program with knowledge of the danger involved and agree to accept all risks of such participation. I certify that the Participant is in excellent physical health and may participate in strenuous and hazardous physical activities, including football, kickball, basketball, and all other activities to be played in the Program. Permission is granted for Participant to receive emergency medical treatment, if needed. I also agree to indemnify and hold harmless those listed above for all claims arising out of Participant’s participation in the Program and all related activities. I agree to let the parties use Participant’s name and likeness free of charge in any manner and for any purpose without compensation to Participant or me. I understand that this document is intended to be as broad and inclusive as permitted by the laws of the state in which the Program is taking place and agree that if any portion of this Agreement is invalid, the remainder will continue in full legal force and effect. I further agree that any legal proceedings related to this waiver will take place in Austin, Texas. I am of legal age and am freely signing this Agreement. I have read this form and understand that by signing this form, I am giving up legal rights and remedies. I represent that I am parent/ legal guardian of the child named above, and I agree that the terms of this release are binding on the child and me. I understand that It’s More Than a Game Inc., Neighborhood Sports, their employees, sub-contractors, volunteers, sponsors, and affiliates have the right to remove participants, family, friends or anyone attending an event from games, the league or programs with or without cause and I release and agree not to sue It’s More Than a Game Inc., Neighborhood Sports, their employees, sub-contractors, volunteers, sponsors, or their affiliates. Parent/Guardian of Participant This is to certify that I, _________________________________________(please print name), as the parent/guardian with legal responsibility for the above named Participant, consent and agree to the above authorization and, for myself and on behalf of my heirs, assigns and next of kin, hereby release, indemnify and hold harmless the Authorized Parties with respect to any and all injury, loss or damage, arising out of this authorization, whether from the negligence of any or all of the Authorized Parties or otherwise, to the fullest extent permitted by law. _____________________________________________ Parent/Guardian Signature
__________________ Date Signed
______________________________________________________________________ Home Address (Please Print) ______________________________________________________________________ Email Address
_______________________________ Phone
At Concordia University st
th
Neighborhood Sports: Basketball League for Boys & Girls in 1 - 8 Grade Co-Ed Boys & Girls Basketball: 1/2 grade, 3/4 grade, 5/6 grade, 7/8 grade Game Format: Full Court Basketball Game Location: Concordia University (FM 620) Season: Games played on Mondays / Tuesdays at 6pm, 7pm, 8pm, 9pm… 6 week season (5 games and playoffs) Schedule: June 13/14, 20/21, 27/28, July 11/12, 18/19 End of season tournament is July 25/26. Register on-line at WWW.NSPORTS.US or by Fax: 512-257-3524 Register by Mail – Mail to: Neighborhood Sports Program @ 2000 Windy Terrace, Suite 7B, Cedar Park, TX 78613
Regular registration ends May 12, 2016 or when League becomes full. Late fee after May 12 ($20) (if space is available) – No Refunds
Basketball League Registration Categories: Volunteer Head coaches child $120 Regular Player $140
Donation…Help kids play who can’t afford to pay (I am donating $________) Players Name:
Parents Name:
Basketball Experience (circle one): Emergency phone: Age:
Birth Date:
Home phone:
New player
Experienced Player
Address: Grade:
(Circle one)
Zip
School:
Email: (required) Only Head coach’s child gets a discount
Very Good Player
City
Male / female (circle one)
Cell phone:
Friend / coach request
Head Coach
Assistant Coach
Team Parent
Code of Conduct and Sportsmanship Policy _____ Parent Initials
I have read the Code of Conduct and Sportsmanship Policy as posted under “Forms” on the www.neighborhoodsports.us website and understand that any violations may result in disciplinary action that could include, but is not limited to the following: verbal warning by official, Neighborhood Sports Director; ejection from field/gym; parental game suspension, game forfeit; or season suspension with no refund of fees.
Parents/Legal Guardians Please sign and submit attached (page 2) Participant Authorization to use Name, Likeness and Voice along with the Parent Release/Waiver Parent/ Legal Guardian signature _______________________________________________ Date ______________ ($4.00 Processing fee will be charged for all Credit Card Payments)
Payment: Check # _____ Cash ___ Credit (V/MC) __ __ __ __ -__ __ __ __ -__ __ __ __ - __ __ __ __ Exp. Date __ __ Register by Fax / credit card: (512) 257-3524
For more Information call 512-918-3524
Neighborhood Sports, a program offered by “It’s More Than a Game”, is an exempt organization under Section 501c3 of the IRS code. “Approval of distribution of these materials is in no way an endorsement of such services, activities, and/or products by the Leander, Austin, or Round Rock Independent School Districts.”
Participant Authorization to use Name, Likeness and Voice In consideration for being allowed to participate in the Neighborhood Sports NFL Flag football games and other related events and activities (individually and collectively, ”The Event”), I hereby authorize, license, permit and grant to I.M.T.A.G. LLC and Neighborhood Sports, assigns, successors, sponsors, sponsoring agencies, advertisers, and owners or lessors of premises used in connection with the Event, and their respective officers, directors, partners, members, shareholders, employees, agents, independent contractors and representatives (collectively, the “Authorized Parties”), the right to use, reproduce, print, publish or disseminate in all manners and media now known or subsequently developed, in all social media, broadcast, promotion, advertising, information, press releases and press conferences or announcements for the Event or other Neighborhood Sports programs or events, my name, likeness and voice. I understand the Authorized Parties have no obligation to use my rights of publicity in any materials. I, for myself and on behalf of my heirs, assigns and next of kin, hereby release, indemnify and hold harmless the Authorized Parties with respect to any and all injury, loss or damage, arising out of this authorization, whether from the negligence of any or all of the Authorized Parties or otherwise (Including from the Authorized Parties’ use of my rights of publicity), to the fullest extent permitted by law. I HAVE READ THE ABOVE AUTHORIZATION, FULLY UNDERSTAND ITS TERMS AND UNDERSTAND THE RIGHTS THAT I HAVE GRANTED BY SIGNING BELOW. I SIGN THIS AUTHORIZATION FREELY AND VOLUNTARILY, WITHOUT ANY INDUECEMENT OR COERCION _____________________________________ Participant Name
______________________ Date of Birth
Parent Release/Waiver In return for my child (*Participant) being allowed to participate in the Neighborhood Sports program (Program), I release and agree not to sue It’s More Than a Game Inc., Neighborhood Sports, their employees, sub-contractors, volunteers, sponsors, and affiliates from all present and future claims that may be made by the Participant or me, my family, estate, heirs or assigns for property damage, personal injury or wrongful death arising as a result of the Participant’s participation in the Program and caused by the ordinary negligence of the parties listed above, wherever, whenever, or however the same may occur. I understand and agree that those listed above are not responsible for any injury or property damage arising out of the Program, even if cause by their ordinary negligence. I understand that participation in the Program involves certain risks, including, but not limited to, serious injury. I am voluntarily allowing Participant to participate in the Program with knowledge of the danger involved and agree to accept all risks of such participation. I certify that the Participant is in excellent physical health and may participate in strenuous and hazardous physical activities, including football, kickball, basketball, and all other activities to be played in the Program. Permission is granted for Participant to receive emergency medical treatment, if needed. I also agree to indemnify and hold harmless those listed above for all claims arising out of Participant’s participation in the Program and all related activities. I agree to let the parties use Participant’s name and likeness free of charge in any manner and for any purpose without compensation to Participant or me. I understand that this document is intended to be as broad and inclusive as permitted by the laws of the state in which the Program is taking place and agree that if any portion of this Agreement is invalid, the remainder will continue in full legal force and effect. I further agree that any legal proceedings related to this waiver will take place in Austin, Texas. I am of legal age and am freely signing this Agreement. I have read this form and understand that by signing this form, I am giving up legal rights and remedies. I represent that I am parent/ legal guardian of the child named above, and I agree that the terms of this release are binding on the child and me. I understand that It’s More Than a Game Inc., Neighborhood Sports, their employees, sub-contractors, volunteers, sponsors, and affiliates have the right to remove participants, family, friends or anyone attending an event from games, the league or programs with or without cause and I release and agree not to sue It’s More Than a Game Inc., Neighborhood Sports, their employees, sub-contractors, volunteers, sponsors, or their affiliates. Parent/Guardian of Participant This is to certify that I, _________________________________________(please print name), as the parent/guardian with legal responsibility for the above named Participant, consent and agree to the above authorization and, for myself and on behalf of my heirs, assigns and next of kin, hereby release, indemnify and hold harmless the Authorized Parties with respect to any and all injury, loss or damage, arising out of this authorization, whether from the negligence of any or all of the Authorized Parties or otherwise, to the fullest extent permitted by law. _____________________________________________ Parent/Guardian Signature
__________________ Date Signed
______________________________________________________________________ Home Address (Please Print) ______________________________________________________________________ Email Address
_______________________________ Phone
