2017-2018 Cosgriff Basketball Registration
Girls & Boys Basketball 2nd-8th Grade
School Attending 2017-18
Registered Parish
Athlete must attend JE Cosgriff School or family must be parishioners of St Ambrose in order to register.
Your answer
First Name
Your answer
Last Name
Your answer
Gender
Grade
Player Experience and Skill Level
Required
If you could choose ONE classmate or friend to be on your team who would it be?
Your answer
Parent/Guardian #1 (First and Last Name)
Your answer
Parent/Guardian #1 (Phone)
Your answer
Parent/Guardian #1 (Email)
Your answer
Parent/Guardian #2 (First and Last Name)
Your answer
Parent/Guardian #2 (Phone)
Your answer
Parent/Guardian #2 (Email)
Your answer
Emergency Contact (First and Last Name)
Your answer
Emergency Contact (Phone #)
Your answer
Emergency Contact (Email)
Your answer
Relation to Student Athlete
Your answer
As a Parent I am willing to?
Safe Environment and Background Check with St Ambrose?
Sportsmanship Motto
Let the players play, Let the coaches coach, Let officials officiate, Let the spectators cheer positively
Consent to Participate
Required
Youth Code of Conduct
Permission to Use
Participant Uniform Shirt Size
Participant Uniform Short Size**
If different than shirt size**
Your answer
Healthy & Fit to Play
Relevant Medical Conditions?
Your answer
Contagious Diseases?
Your answer
Current Medications?
Your answer
Medical Treatment
Insurance Information
Your answer
Liability Release and Waiver Agreement
Required
Participation Fee $100 (Charged to FACTS account on 10/24)
Required
Late Fee $25 (After 10/23)
We will not be able to accept registration after 3pm on 10/27
Required
Sponsorship or Donation
Your answer
Grade levels that require two or more teams will be determined by school Athletic Directors and Administration with a fair and balanced approach.
Electronic Signature
Your answer
Submit
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