DISCIPLES TRYOUTS APPLICATION
PLAYER'S INFO
Email address *
Playerxj j.lo *
Your answer
Address *
Your answer
City, State, Zip *
Your answer
Player's Cell Phone *
Your answer
Email Address *
Your answer
Birthday *
MM
/
DD
/
YYYY
School *
Your answer
Grade *
Graduation Year *
Your answer
Height *
Position Trying Out for *
Did you play in Elementary School *
If "yes" what was the name of the team
Your answer
Did you play in Middle School *
If "yes" what is the Coach name & number
Your answer
Did you play in High School *
If "yes" what is the Coach name & number
Your answer
Did you play on a summer travel team *
If "yes" what was the name of the team
Your answer
Wavier
I hereby release and discharge the Memphis Disciples, their authorized representatives, staff and volunteers from all liabilities, of any kind or character, upon any claim, or cause of action, which might be asserted on behalf of said applicant against staff of volunteers. Furthermore, in the event of an accident or illness, I hereby grant permission to said staff or representative to administer first aid and/or transport applicant to the nearest medical facility for treatment. I accept full responsibility for any financial obligation concerning this matter. I understand that I am responsible for sports relate activities for my child. I grant permission for my child to participate in this program. Tennessee law requires the Memphis Disciples' and subsidiaries' staff or volunteers to report any and all incidences of abuse and/neglect of minor children.
Name *
Your answer
Date *
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
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