SYB Registration Form

Sultan Youth Basketball
2013 -2014 Fall Camp and Winter League

Sponsored by: Sultan Youth Basketball Club
2013 - 2014 SULTAN YOUTH BASKETBALL WINTER LEAGUE / SWISH WAIVER

In consideration of your accepting my entry, I hereby for myself, my child, or children when applicable, my heirs, executors, and administrators waive and release any and all rights and claims for damages I or my child(ren) may have against Sultan Youth Basketball (SYB) and its representatives, successors, or assignees, for any and all injuries suffered by myself or my child(ren) while going to, participating in, or returning from SYB activities. I hereby authorize the operators of SYB to seek medical attention for my child in the event I cannot be reached. I have read this statement and my signature below verifies mine and my child's acceptance of these conditions.
Choose one:
Participant 1 (required)
Participant 1 Name:

First NameLast Name
Grade:
Birth Date:

MonthDayYear
Shirt Size:
Participant 2 (optional)
Participant 2 Name:

First NameLast Name
Grade:
Birth Date:

MonthDayYear
Shirt Size:
Participant 3 (optional)
Participant 3 Name:

First NameLast Name
Grade:
Birth Date:

MonthDayYear
Shirt Size:
Parental information (required)
Parent's Name:

First NameLast Name
Address:

Street Address

Street Address Line 2

CityState / Province

Zip CodeCountry
Cell Phone:

Area CodePhone Number
Home Phone:

Area CodePhone Number
Work Phone:

Area CodePhone Number
Parent 1 email:
Parent 2 email:
Allergies:
Health Concerns:
I am willing to volunteer with SYB in one of the following areas:
Choose one or more:
PayPal payment information
If you plan on paying with an alternative method, do not choose an option below.
Choose one:
prevnext( X )
1 child$50.00

2 children$100.00

3 children$150.00
Sultan Youth Basketball (SYB) is a non-profit basketball club based within the borders of the Sultan School District. It is staffed by volunteer community members who are dedicated to providing an environment where our youth can develop as well-rounded citizens and athletes.
Should be Empty:

Sultan Youth Basketball

Participant 1 (required)

Participant 2 (optional)

Participant 3 (optional)

Parental information (required)

PayPal payment information

Choose one: