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Individual Basketball Registration Form
Season: January-February
Registration: November 23rd- December 2nd
Grades: 1st-6th grade
Fee: $30 to be paid online at www.TonkawaChamber.org
Contact us at (580) 628-2220 or info@TonkawaChamber.org
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Child's name *
Are you a Tonkawa Tribal member? *
Birthday *
MM
/
DD
/
YYYY
Age *
Grade *
Sex *
T-Shirt Size *
Required
Medical Conditions/Allergies & Treatment if Applicable *
Parents name *
Phone number *
Email Address *
Address *
Medical Insurance Carrier *
Policy Number *
Interested in Coaching? *
Emergency Contact #1 Name, Number, Relationship * *
Emergency Contact #2 Name, Number, Relationship * *
Liability Waver - I do hereby release Tonkawa Chamber of Commerce and Tonkawa Youth Sports, its coaches and board members, and Tonkawa Public Schools and its employees that are associated with Tonkawa Youth Sports, from any and all liability, related to any incident or injury that may occur as a result of my child’s participation in the Tonkawa Youth Sports. I further agree to not pursue any legal action against the above names entities, nor its board members, coaches and employees, and I agree to provide proper insurance for my child. * *
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