PLAYER INFORMATION

Player's Name*

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Birthday*

Grade Level*

Team*

T-Shirt Size*

IMPORTANT NOTE: Once the grade level is set at 9th grade or above, the player must advance to the next grade level each year.

Address*

Home Phone

Cell Phone

PARENT INFORMATION

Parent Contact(s)*

Father

Mother

EMERGENCY CONTACT INFORMATION

Emergency Contact Name*

Emergency Contact Phone*

Relationship To Player*

WEBSITE PHOTO CONSENT

By checking the 'I Agree' box below, I am giving my consent to allow photos of my son to be displayed on the St Louis Patriots Homeschool Boys Basketball website. It's my understanding that my son's name will not be posted with any photographs on the website.

Photo Consent*

I Agree

PARTICIPATION WAIVER

By checking the 'I Agree' box below, I am agreeing that I will not hold any of the coaches/staff or instructors responsible for any injuries sustained by my son while participating in any St. Louis Patriots basketball activities for the 2018-2019 season. I also give permission for the staff to treat my son to the best of their abilities should an injury occur. By checking the box below, I agree that my son is in good health and has no known physical limitations or disabilities that might present any danger to him because of his participation in St. Louis Patriots basketball sponsored activities.

Participation Waiver*

I Agree

PARENT / LEGAL GUARDIAN

I the undersigned, acknowledge that I am submitting this online form as either the player's parent or legal guardian.

Signature*