Blue Collar Basketball Academy

North Paulding High School 2nd through 8th grade boys and girls
When: Sunday nights 6 p.m. to 8 p.m. North Paulding High School main gym Cost: $30 per session or $100 per month What: Extensive off-season basketball fundamental instruction conducted by varsity boys head coach Ryan Dyer and varsity girls head coach Scott Green and staff Dates:
March 9, 16, 23, 30, - $30 per session or $100 per month April 20, 27 - $30 per session or $50 per month May 4, 11, 18, 25 - $30 per session or $100 per month August 10, 17, 24, 31 - $30 per session or $100 per month September 7, 14, 21, 28 - $30 per session or $100 per month October 5, 12, 19, 26 - $30 per session or $100 per month

Blue Collar Basketball Helping young players take their game to the next level! NorthPauldingBasketball.net

2013/2014 BASKETBALL ACADEMY REGISTRATION

NAME: ____________________________ AGE:___________

GRADE:__________ GENDER BOY OR GIRL CURRENT SCHOOL __________________

PARENTSNAME:________________________________________________________________ EMAIL:__________________________________________________________________________

HOME PHONE: _________________________

WORK PHONE: _________________________

Mail Checks to Attn: Ryan Dyer/Scott Green 300 North Paulding Drive Dallas GA 30132 Make Checks Out to: NPBPGC Or make payment on the day of Basketball Academy. We accept Cash, Checks, or Credit Card
General Release, Waiver of Liability and Hold Harmless Agreement KNOW BY ALL MEN BY THESE PRESENTS, That _______________________________(Print parent/guardian name) hereby agrees to indemnify and hold harmless the North Paulding Basketball Point Guard, NPB PGC Board of Directors, NPHS and the Paulding County School District against any and all liability, loss, damages, costs, rights and causes of action of whatsoever kind and nature, specifically including, but not limited to, bodily and personal injuries of the undersigned or ___________________________(print player name) as their minor child, as well as all hospital bills, doctor bills, drug bills, and other medical expense, general and punitive damages, that may result from any incident occurring while enroute to or from, or while on the premises of the facilities used by North Paulding Basketball Association. It is expressly agreed that the undersigned fully understands that the execution of this document will prevent the undersigned or _________________________, (print player name) their minor child, from asserting any claim as set forth herein, sustained while on the premises or enroute to or from said premises.

Signature of Parent/Guardian________________________________

Date: ________________

I understand that participation in the Blue Collar Basketball Academy in no way has any bearing on my son/daughter and their participation in future North Paulding basketball junior wolfpack or high school team selection.
Signature of Parent/Guardian________________________________ Date: ________________