Village of Lewiston Recreation Paul Mamon Memorial 3-on-3 Boys Basketball Tournament Team Registration Form
Village of Lewiston Recreation Address: 145 N. 4th Street, Lewiston, NY 14092
Contact us at (716) 754-1990 or recreation@villageoflewiston.com

RELEASE OF LIABILITY
In consideration of permitting the below-named child to participate in games, practices, and other activities of the Village of Lewiston Recreation Department, I, the undersigned as parent or guardian of said minor, do hereby release and agree to hold harmless the Village of Lewiston Recreation Department and its said agents, employees, coaches and volunteers from any liability for bodily injury, personal injury or property damage which may occur to said minor on the part of said program or its agents, employees, coaches and volunteers related to this program.
Tournament Date: Saturday, August 17, 2019 from 9am-2pm
• Maximum Four Boys per team

• Deadline Monday, August 5, 2019

• $15.00 entry fee per player and will include game shirt, pizza and a drink.

• Age groups: 11 to 13 and 14 to 16 years of age

Tournament is bracket style is determined based on the number of teams.

**All team members must complete a liability release and emergency number form, which is attached to this form.**

Team Name *
Your answer
Team Age Group *
Required
Player 1 (Captain) Name *
Your answer
Player 1 (Captain) Home Address *
Your answer
Player 1 (Captain) Phone Number *
Your answer
Player 1 (Captain) Date of Birth *
MM
/
DD
/
YYYY
Player 1 (Captain) School Attending *
Your answer
Player 1 (Captain) T-Shirt Size *
Required
Player 2 Name *
Your answer
Player 2 Home Address *
Your answer
Player 2 Phone Number *
Your answer
Player 2 Date of Birth *
MM
/
DD
/
YYYY
Player 2 School Attending *
Your answer
Player 2 T-Shirt Size *
Required
Player 3 Name *
Your answer
Player 3 Home Address *
Your answer
Player 3 Phone Number *
Your answer
Player 3 Date of Birth *
MM
/
DD
/
YYYY
Player 3 School Attending *
Your answer
Player 3 T-Shirt Size *
Required
Player 4 Name (Optional)
Your answer
Player 4 Home Address (Optional)
Your answer
Player 4 Phone Number (Optional)
Your answer
Player 4 Date of Birth (Optional)
MM
/
DD
/
YYYY
Player 4 School Attending (Optional) *
Your answer
Player 4 T-Shirt Size (Optional)
I understand that EACH player will have to pay $15 and that covers the cost of team t-shirts, pizza and drinks. *
Required
Basketball Tournament Flyer
3-on-3 Boys Basketball Tournament Liability Form
3-on-3 Boys Basketball Tournament Rules
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