Brazos Basketball League

Registration Form
Name:______________________________________________
Address:____________________________________________
City:______________________ State:______ Zip:_______________
Birth Date:____/_____/_____ Gender: M or F
Telephone #:_______________________ E-mail:___________________________
Emergency Contact:__________________________ Phone:________________
For players under 18 years of age:
Parents Name:________________________ Cell Number:________________________
Grade: ____ School:_________________________ Highest level played:____________
I/We verify that this player is physically able to participate in the Brazos Basketball League. I/We, the below signed, as parent(s) or legal
guardian(s) of the above listed player, understand there are certain risks and hazards associated with any and all activities and agree to
accept the responsibility for medical services if necessary for the above player. I/We do hereby waive, release, absolve, indemnify and agree
to hold harmless the Brazos Basketball League, the organizers, coaches, sponsors, supervisors, participants and persons involved in league-
sanctioned activity or those transporting my/our child for any cause and release them from all liability. I/We, the parent(s) or guardian(s), give
my/our permission for any emergency treatment necessary, either during practices, games, or in the emergency room. I/We give permission
for my/our child to participate in the Brazos Basketball League.

Parent Signature :_____________________________________________ Date:________________

Team Desired:________________________________ Don’t have a team? Check the

Team Captain:________________________________ box to become a Free Agent:

League Desired(Cost): Competitive($50) Recreational($45) Co-ed($45)

Game Day Preferred: T W Th Sat Sun

By registering in the Brazos Basketball League, I have hereby waived, released, absolved, indemnified and
agreed to hold harmless the Brazos Basketball League, the organizers, coaches, sponsors, supervisors,
participants and persons involved in league-sanctioned activities and have released them from all liability. I
understand the risks inherent in physical activities and basketball in particular, the potential for injury, and agree
to release any and all claims for damages against the Brazos Basketball League. Furthermore, I understand that I
must display sportsmanship at all times and respect all Brazos Basketball League officials, referees, participants,
and organizers. I also give permission to the Brazos Basketball League to use photos of your participation in any
promotional purposes, including, but not limited to: internet, print, and television advertising.

Player Signature:_________________________________________________Date:_________________

Please send check or cash to: Brazos Basketball League

P.O Box 9127
College Station, TX, 77842