ADVANCED SKILLS ENROLLMENT FORM

 

Coach's Name:




Team Area:




Player Name:




Birth Date:




Player Address:




Parent Name:




Parent Relationship:




Home Number:




Work Number:




As a parent/guardian of the above named participant of YMCA basketball, I hereby agree to abide by the rules and regulations set up by the Anchorage Community YMCA. I further agree to accept complete responsibility in matters of physical injury or loss that might result from such participation in games, practices or travel to or from such activities. I further agree that in the event of such injury or loss, there shall be no liability on the part of the Anchorage Community YMCA, Anchorage School District, YMCA volunteers or any of the sponsoring bodies associated with the sponsorship of this activity.

YMCA YOUTH SPORTS MEDICAL RELEASE

In the case of emergency, I authorize the Anchorage Community YMCA and/or volunteer coach to give permission for appropriate medical or surgical care for the above named player. In the event I cannot be reached, it is understood that a conscientious effort will be made to locate me or my child's emergency contact person.
Emergency Contact Person




Phone:




Parent/Guardian Signature:




Date:




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