NYS: Rascals Basketball 2020
Please fill out completely.

YOU WILL BE CONTACTED ONCE DATES AND TIMES HAVE BEEN DETERMINED. THANK YOU FOR YOUR PATIENCE AND UNDERSTANDING. WE APPRECIATE YOUR CONTINUED SUPPORT OF OUR ORGANIZATION

Email address *
Player's First Name *
Player's Last Name *
Player's Birthday *
MM
/
DD
/
YYYY
Player's Age (as of September 2, 2020) *
Boy or Girl *
T-shirt size *
Does your player want a basketball? (Please note it is an additional $5.00) *
Grade (Fall 2020) *
Is your child a returning Rascals player? *
If yes, what is the most recent session they attended? (Example Summer 2019, Fall 2018...)
If possible, please place on a team with:
Basketball Experience *
Is your child interested in playing basketball for in the future for NYS *
Are you or any of your family members associated with another sports club or other Asian basketball organization? Please note their name/or the organization's name: *
Parent/Guardian's name *
Contact phone number (include area code) *
Email address: *
Address *
City *
Zip Code *
Volunteer: Would you like to help with one of the following:
Clear selection
Authorization for third party to consent to treatment of a minor lacking capacity to consent and photo release agreement.
We, the parents/guardian of the player participating as designated in the application, in the event our minor child becomes ill or sustains an injury while in the care or under the supervision of the managers, coaches, or other representatives of Norwalk Youth Sports , they are given permission to administer first aid for her or his relief. I understand an attempt will be made to contact me/us at the time of the accident or illness if time permits. If it is not practical to return her or him to us or to receive our instructions for their care consent is given to have any medical or surgical treatment performed as any licensed physician deems necessary for the relief of pain and to preserve their life and health. I/we hearby hold harmless Norwalk Youth Sports, the Southeast Japanese School and Community Center, its members, coaches, and staff for any liability, including injuries, in connection with the Rascals Basketball Program. I/We agree to abide by the rules and regulations of the NYS Rascals Basketball program. I also grant the Norwalk Youth Sports “NYS” Rascals Program, a club organized under the Southeast Japanese School and Community Center “SEJSCC” the right to use any photographs or video taken of me and my family while participating with and/or attending the Rascals program. I authorize the NYS, SEJCC, its assignees, and transferees, to copyright, use and publish such photographs in print and/or digital form. I agree that NYS and /or SEJSCC may use such photographs with or without name for any lawful purpose, including, for example such purposes, including, for example, such purposes as publicity, illustration, advertising or web content, I have read and understood the above release and agree to its conditions without any future consideration. *
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy