2020-2021 BOYS Rec Basketball Registration
Please fill out this form for each registering player for the Oak Mountain Boys Recreational Basketball League, created specifically for boys residing in and/or attending a school in the Oak Mountain School district and are currently in grades 2nd, 3rd, 4th, 5th or 6th.

Player evaluations along with practice and game dates are still being determined. Plan to practice once a week and attend games on Saturday afternoons. All events will held at Oak Mountain Middle School unless otherwise noted.  

Any questions regarding this form or if you have any challenges with using it, please contact the league via our email address OMBoysRecBasketball@gmail.com Please feel free to share this form and contact information to anyone interested!
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Player's First Name
Player's Last Name
Age
Birthdate
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2020-2021 Grade in School
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School currently attending
Player's Height
Please list previous basketball experience and include current or former teams played on:
T-Shirt Size for PARTICIPANT; (T-shirt is included with registration at no added cost)
Please list any physical or medical limitations your coach will need to be aware of:
List any known allergies to medications:
List any other medical information or history that coaching staff and organizers should be aware of:
Doctor or Pediatrician's name, address, phone number:
Preferred hospital:
Participant's full physical address (house #, street, city, zip):
Participant's "home" phone number:
Participant's insurance company name and policy #:
Parent/Guardian name, email, and best number to contact:
Parent/Guardian 2 name, email, and best number to contact:
Is anyone in your household a Shelby County Employee? If so, what is your title:
Clear selection
Emergency contact (other than parent) name, relationship:
Emergency contact's home and cell number
I would like to help in the following ways - check all that apply
NOTES:
Please read and agree to the following:  In my legal capacity as parent/guardian of the minor named above (“Minor”), acknowledge and agree that any use of the Oak Mountain Middle School or Oak Mountain High School facilities, services, equipment and premises (“Facilities”) and any participation in the Oak Mountain Boys Rec Basketball program (“Program”) comes with inherent risks including, but in no way limited to: (1) moderate and severe personal injury, (2) property damage, (3) disability, (4) death, and (5) sickness or disease including, without limitation, COVID-19. I voluntarily, for myself and Minor, accept and assume full responsibility for these risks as well as any and all other risks of the use of Facilities and participation in Program. I agree that I have full knowledge of the nature and extent of all such risks and am not relying on all such risks being described in this document.  Waiver, Release, Indemnification & Covenant Not to Sue In consideration of Minor’s use of Facilities and participation in Program I, in my legal capacity as parent/guardian of Minor, agree on behalf of myself and Minor that Oak Mountain Middle School, Oak Mountain High School, Oak Mountain Boys Rec league officials, its employees, officers, directors, agents, volunteers, insurers, and representatives (“Releasees”) will not be liable for any personal injury, property damage, disability, death, sickness or disease incurred by Minor, however occurring including, but not limited to, the negligence of Releasees. I understand that Minor and I will be solely responsible for any loss or damage, including personal injury, property damage, disability, death, sickness or disease sustained from the use of Facilities and participation in Programs.  I further agree, in my legal capacity as the parent/guardian of Minor, on behalf of Minor, myself, and any and all legal successors and proxies, to release and HEREBY DO RELEASE, WAIVE AND COVENANT NOT TO SUE Releasees from any causes of action, claims, suits, liabilities or demands of any nature whatsoever including, but in no way limited to, claims of negligence, which Minor, myself, and any and all legal successors and proxies may have, now or in the future, against Releasees on account of personal injury, property damage, disability, death, sickness, disease or accident of any kind, arising out of or in any way related to the use of Facilities or participation in Programs, whether that participation is supervised or unsupervised, however the injury or damage occurs, including, but not limited to, the negligence of Releasees.In further consideration of the use of Facilities and participation in Programs, I, in my legal capacity as parent/guardian of Minor, agree on behalf of myself and Minor to INDEMNIFY AND HOLD HARMLESS Releasees from any and all causes of action, claims, demands, losses, suits, liabilities or costs of any nature whatsoever, including claims of negligence, arising out of or in any way related to the use of Facilities and participation in Programs. *
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Time and date completed:
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