Tyrone Doleman's Basketball Skills Camp

4443 Hiawatha Ave So., Minneapolis, MN  55406 - Office:  612-721-9400  Cell:   612-735-7242  

Email:  mplsladylakers@yahoo.com

 PLAYER REGISTRATION FORM

PARENTS AND PLAYERS, please read and indicate your agreement by signing below:

I hereby approve my child’s participation in the Tyrone Doleman's Basketball Skills Camp and consent to emergency medical treatment for my child on my behalf.  To the best of my knowledge, there are no physical or other conditions, which will interfere with my child’s participation.  The Tyrone Doleman's Basketball Skills Camp as well as any host location we play our activities in, will assume no liability for injury or damage arising from the results of participation.  Basketball presents certain inherit risks and hazards, which the participant and his/her parent or legal guardian is/are urged to consider, and which the participant assumes.

PLEASE FILL IN ALL BOXES-YOUR FORM WILL NOT BE RECEIVED IF YOU DON'T!

ATHLETE'S NAME I AGREE TO THE ABOVE WAVER

PARENT'S NAME I AGREE TO THE ABOVE WAVER

PLAYER'S BIRTH DATE:  MONTH   DAY   YEAR

HOME ADDRESS

CITY   STATE   ZIP CODE

ALL 6 NUMBERS ARE REQUIRED.  INCLUDE AREA CODE.  REPEAT NUMBERS IF YOU MUST.

HOME #   MOM'S WORK #   DAD'S WORK #

PLAYER'S CELL #   MOM'S CELL #  DAD'S CELL #

PLAYER'S E-MAIL ADDRESS  

SCHOOL ATTENDED IN 2006-2007  

GRADE COMPLETED 2006-2007  

PLAYER IS IN CLASS OF  

 2006-2007 WINTER TEAM NAME  

2006 AAU TEAM   POSITION   HEIGHT  

T-SHIRT SIZE

HOW DID YOU FIND OUT ABOUT THE Tyrone Doleman's Basketball Skills Camp?

Please remit your camp fee to:

Tyrone Doleman's Basketball Skills Camp

4443 Hiawatha Ave. S.

Minneapolis  Minnesota  55406

 

Copyright © 2007 MPLS. LADY LAKERS. All rights reserved.
Revised: 03/31/07.