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2018 Friday Night Hoops @ The Y
This form MUST also be completed by a parent/guardian of participant is 17 years old or younger. Participation is only allowed once this form AND payment have been received. Please contact Jon Reimer at jreimer@superioryma.org if you have any questions.

League play begins Friday, February 2. Games start at 7:00 and 8:00pm. Participants will receive further communications from Superior YMCA regarding all league regulations.

LAST NAME *
Your answer
FIRST NAME *
Your answer
Player's phone number *
Your answer
Player's email address *
Your answer
Team Name *
Your answer
Who are your teammates? (5-player minimum, 10-player max) *
Your answer
CURRENT GRADE IN SCHOOL *
What school are you attending?
Your answer
Parent(s) Name(s) *
Your answer
PARENT'S EMAIL ADDRESS *
Your answer
MAILING ADDRESS *
Your answer
PARENT'S PHONE NUMBER *
Your answer
PARTICIPANT'S jersey size *
Name of your team's ADULT coach/supervisor *
Your answer
Coach's email address *
Your answer
Coach's phone number *
Your answer
(MUST BE READ BY PARENT/GUARDIAN) I hereby give my permission and approval for the above-named student to participate in the 2018 Friday Night 4-on-4 Hoops season. I assume all risks and hazards incidental to such participation, and I release the YMCA, supervisors, and coaches from any claim arising from an incident or injury to my child. I also understand that athlete's photo may be used for future promotional efforts. If I object, I must communicate via email or in written form with Jon Reimer, the YMCA's Aquatic & Sports Director. *
Required
Have you already paid the $40/player participation fee? *
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