2019 OLQM Intramural Basketball Registration Form
Dates: March 10, 17, 24, 31 and April 7 for Kindergarten through 5th grade

****Players that are finished with CYO may participate in Intramural basketball up to 5th grade.


REGISTER BEFORE MARCH 1ST AND SAVE $10 (K-2 $50 and 3-4 $60) pricing after March 1st (K-2 $60 and 3-4 $70) for 5 weeks.

Email address *
Player's First Name *
Your answer
Player's Last Name *
Your answer
Check Session *
Required
Current Grade *
Parent's Name: *
Your answer
Address, City & Zip *
Your answer
Contact Number *
Your answer
Parent Email: *
Your answer
Cost: *
Required
Total amount sent to School Office (Check Payable to OLQM) *
Your answer
Volunteer's Name:
In order for the intramural program to be successful, we need parents to volunteer to coach. Volunteers will be asked to work at stations, teaching specific fundamentals demonstrated by the Intramural Director. If you are willing to volunteer all five weeks at one session you will recieve half off the registration cost for your child in that session you are volunteering in.
Your answer
Volunteer's Phone Number:
Your answer
Volunteer's Email:
Your answer
Emergency Contact Information Name: *
Your answer
The above player has my permission to participate in OLQM intramural Basketball Program. My son/daughter is in good health and I understand that participation involves risk of serious injury. I agree to assume full personal and financial responsibility and release and agree to hold harmless Our Lady Queen of Martyrs School (including director, volunteers, coaches, officials and employees) for liability for any injuries, stolen or damaged possessions, liability, losses, costs, or any other damages that may be incurred as a result of the above player participation.
Checking this box is your electronic consent to allow the above player to participate. Must be a Parent or Legal Guardian to complete.
Emergency Contact Number: *
Your answer
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