2019 DIBCA Showcase Athlete Questionnaire and Emergency Information
This information will be shared with college coaches so that they can communicate with your son's high school coach about his attitude, skill and athletic ability, academics, and team work.
Last Name of Student Athlete *
Your answer
First Name of Student Athlete *
Your answer
Height *
Your answer
Weight *
Your answer
Grade Point Average (GPA) *
Your answer
Anticipated Academic Grade Level for 2019/2020 *
Class Rank (Optional)
Your answer
Full Name of Parent or Guardian Completing this form and making payment. *
Your answer
Email of Parent or Guardian *
Your answer
Phone number of Parent or Guardian *
Your answer
Parent/Guardian Acknowledgement: Basketball is a physical sport and injuries may occur. Smyrna School District or DIBCA or its members are not liable for any incidental injuries that may occur during the event. *
Required
Parent/Guardian are responsible for making sure that their child is cleared to play basketball without restrictions prior to this event. *
Required
In the event of an injury Parent/Guardian gives the onsite athletic trainer and DIBCA members permission to give first aid to your child. *
Required
Smyrna School District, DIBCA, and it's members are not responsible for any stolen cell phone or electronic devices or personal property. *
Required
Full Name of Emergency Contact *
Your answer
Phone Number of Emergency Contact *
Your answer
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