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ADVANCED SKILLS ENROLLMENT FORM
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| Coach's Name:
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Team Area:
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| Player Name:
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Birth Date:
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| Player Address:
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| Parent Name:
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Parent Relationship:
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| Home Number:
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Work Number:
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| 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. |
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| Emergency Contact Person
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Phone:
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| Parent/Guardian Signature:
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Date:
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