Registration Form – Player Profile

Premier Basketball Training

Premier Basketball Training
Player Profile Sheet

(Personal Information)

 

Client's Name: *  
Parent Name: * E-mail: *
Address:    City:   
State:    Zip:   
Home Phone: * Cell:   
Age: * DOB:   
Height: * Weight: *
Pos: * School Attending: *
Any medical problems within last 3 years: *
Person to notify in case of an emergency: *
Phone: *  

Consent to Perticipate C

I *parent or Guardian of the above name client *

hereby give approval for participation of any and all training sessions and events hosted by Premier Basketball Training.

I furthermore, agree to hold the Premier Basketball Training Program and St. Benedict Catholic Church/Gymnasium and any affiliates harmless of any legal responsibilities of any injuries during the clients training experience. I also acknowledge that my child/client has recently had a physical examination and is cleared to participate in sporting activities.

I understand that I am, my child or client is required to have medical insurance to be cleared to train with Premier Basketball Training.

I confirm by signing below that the information above is accurate and my child/client or I am covered by a primary medical insurance policy and will notify you if he/she or I no longer has coverage.

I also give permission to the Premier Basketball Staff to obtain medical attention for my child/client in case of an emergency.

We reserve all rights to audio, video, photography and media coverage to promote, market and advertisement for our program. We have a No Refund Policy for all events hosted by Premier Basketball Training.

Signature: * Date: *