Baltimore Cougars Youth Basketball Tryouts

Baltimore Cougars Legends

12 and Under Girls

Baketball Tryouts

@Northwestern HS

6900 Park Height Ave,

Baltimore, MD 21215

March 19th, & 20th 2016

11pm- 1pm

Registration Form

(Ages 10-12)

baltimorecougars@gmail..com

Athlete Information

Player Name*

First NameLast Name

Player DOB

MonthDayYear

Guardian / Parents Names*

First NameLast Name

Are you over 18 ?*

YesNo

Parent/Guardian DOB

MonthDayYear

Address*

Street Address

Street Address Line 2

City

Postal / Zip Code

Home Phone*

Area CodePhone Number

Cell Phone

Area CodePhone Number

E-mail*

Interested in Volunteering for student service learning hours, while your team not playing? You must be at least 12 years of age.

TryOutStudent Community OutreachClinics and Camps

I would like to play on the same team with following players. League organizers will form teams base on lottery of your skill level and players you know.( Please leave child's names, Parent name & number.

Important Notes

· Dress appropriately.

· No food or drink in the gym.

· Keep the gym clean.

· The league organizers reserve the right to form the teams to ensure the talents of all teams are balanced.

· Fee: AAU member fee is $18.00. The Fee is required to play with BCL. Memberships to AAU, can be found on www.aausports.org .That fee is due after the selcetion of our roster. BCL is a Non Profit Multi-Sports Organization. We frequenlty apply for grants that help sponsor our BCL Children, Youth, and Thier Parents. All of the money funded, are used towards practice, games, events and travel various items and needs for Baltimore Cougars Legends Organization to stay uniformed, appropratietly displayed, and professionally prepared for Sucess.

· Mission: We have focused this year in the area of Urban Greening.

- Another important sector of our nonprofit focuses on community development. We deeply treasure the value in maintaining the commonness and unity within the community. The athletes are required to have 140 hours a year to play at an collegiate level. This year community service learning hours will deal with Urban Greening projects. Baltimore City has about 17,000 vacant lots, our youth will assist with the transformation of these vacant lots into beautiful fruitful urban centers. By partnering with Blue Lotus OG a medicinal urban farm located in West Baltimore, we have obtained knowledge of how to transform lots into Green Spaces. With the same seeds the youth plant to beautify these lots are going to be the same seeds planted in their minds to incorporate fresh food into their lifestyle to become a fit athlete.

- Apart of our community Outreach as a NOP starts with us as a unit. Parent and Child particpation is required. Our players recieve 8 hours of Student Community Service monthly. We immerse develops that support physical and mental extracurricular outlet, to help youth athletes pursue and achieve an academic and athletic scholarship. We recieve funding towards our leadership and hard work to help profit our organzation. Mandaorty meetings are held while during some practice days for our parents to stay updated with our schdeduled summer itinary.

Will you be able to commit to these community service hours.

Emergency Contact & Health Insurance Information

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Area CodePhone Number

Do you have health insurance ?

YesNo

Insurance Carrier

Name of Policy Holder

Subscriver ID/Group Number

Card Number / Card Date

Do you have any allergies, chronic illness, or medical conditions that would limit high level activtiy?*

YesNo

Please describe*

Parental Permission For Emergency Treatment

In the event of illness or accident, I give my permission for emergency treatment by qualified medical personnel for my child, and I authorize the person in charge to take my child to:
I give consent for the facility to secure any and all necessary emergency medical care for my child.

Name of Physician / Emergency Medical Care Facility

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Area CodePhone Number

Release of Liability

Although the safety of all sport activities is the primary concern, indoor/outdoor sport activities at Baltimore City Recreation and Park Sport Center's facilities and Baltimore Cougars Legends Organization may cause injuries and/or death. I expressly assume the risk of injury, death, and/or illness arising from any cause, and agree to waive the right to pursue any claim against the Baltimore City Recreation and Par Sports Center, Baltimore Cougars Legends Organization and the persons in charge.

I have read and agree to the above conditions*

YesNo

Confirmation E-mail*

Signature*

After completing this form, please click Submit Form. You will receive a confirmation email. If you do not receive the email within a few minutes, please check your spam; otherwise, please contact us at baltimorecougars@gmail.com.