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Player’s Name:______________________________________Grade:______________ Select Shirt Size: Adult S, M, L, XL, Youth Sm, M, L Boy / Girl:______ Address: _______________________________________________________________
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Player’s Name:______________________________________Grade:______________ Select Shirt Size: Adult S, M, L, XL, Youth Sm, M, L Boy / Girl:______ Address: _______________________________________________________________ Home Phone:Cell: _ Email:_________________________ Available to Coach: Yes / No, Assistant Coach: Yes / No Are you willing to Sponsor a team for $100.00: Yes / No Can you play on Saturday? Yes / No…..Can you play on Sunday? Yes / No Health Care Provider:__________ Policy: #:_________ Please make checks payable to: Lancaster Recreation Department Please return form and payment to: LRB c/o B. Duggan Questions: 978-365-2379 234 South Meadow Road Or email: lancasterrecbball@comcast.net Lancaster, MA 01523 Parent Signature:_____________________________________________ By signing above I hereby consent to my child’s participation in the Recreation Department Youth Basketball program. I also agree to forever release the Town of Lancaster, the Recreation Department, and all their volunteers from any and all claims, rights of action and causes of action that may have arisen in the past, or may arise in the future, directly or indirectly, from personal injuries to my child or property damage resulting from my child’s participation in the Town of Lancaster Youth Basketball program. I further affirm that I have read the Consent and Release Form and that I understand the contents of this Form. I understand that my child’s participation in this program is voluntary and that my child and I are free to choose not to participate in said program. By signing this Form, I affirm that I have decided to allow my child to participate in the Town of Lancaster Youth Basketball program with full knowledge that the Releasees will not be liable to anyone for personal injuries and property damage my child or I may suffer in this program. Registration Deadline: September 26, 2008 **Evaluations will be scheduled for early November** Fees: Grades 1-2: $50.00 Grades 3-4: $ 60.00 Grades 5 - 8: $70.00 **$25.00 Late Fee for registrations received after 09/26/08** Lancaster Rec Basketball 2008 - 2009 Season Register Your Sons & Daughters. Now For the Following Divisions: Grade 1-2 Girls and Boys Combined, Grade 3-4 Girls, Grade 3-4 Boys Grade 5-6 Girls, Grade 5-6 Boys, Grade 7-8 Girls and Grade 7-8 Boys
