Spirit of the Doc Youth Basketball Clinic 2022 Registration Form

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Event Timing: Friday December 16, 2022
Event Address: Trinity College Ferris Athletic Center 300 Summit St. Hartford, CT 06106
Contact us at ghpayouth@gmail.com

Player's First Name *

Player's Last Name

Player's Age *

Player's Date of Birth (mm/dd/yy) *

Player's Home Street Address *

Player's Home City

Player's Home Zip Code

Instagram Handle

School *

Grade *

Parent/Guardian Name (First, Last) *

Telephone Number *

Email Address *

Emergency Contact (Name and Phone Number) *

I hereby give permission for my child to participate and play in the Spirit of the Doc. I understand that the sport of basketball can involve contact with other players and the possibility of injury does exist. In the event of an emergency requiring medical attention and I am unavailable, I authorize the coach, assistant coach or any other Spirit of the Doc and Voluntary Staff to act on my behalf, according to their best judgment. I have no knowledge of any physical impairment that would be affected by my child’s participation in this sport. *

Yes

Required

I hereby waive and release the Spirit of the Doc and its coaches, Directors and staff from any and all liability for injuries or illnesses incurred to, from or during the practices and or games. By signing this waiver, I also give permission for the Spirit of the Doc to use photographs taken during sporting events of my child in displays, publications, website, video productions and/or materials for publicity or advertising purposes which may promote the Spirit of the Doc. *

Yes

Required

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