Basketball Registration

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent / Guardian Name *

First Name

Last Name

Phone *

(###)

###

####

Second Parent / Guardian Name

First Name

Last Name

Second Parent/Guardian Phone

(###)

###

####

Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone *

(###)

###

####

Release of liability *

I/We as the parent(s) or legal guardian of the child listed on this registration, understand the above named child will be participating in activities for/with Holbrook Recreation. I/We release the Holbrook Recreation from any and all liability of whatever form which may arise as a result of any injury during the 25-26 season. I/We are giving the above said child permission to participate in the season and take full responsibility for said child.

Yes

Are you willing to volunteer? *

Yes!

Not at this time