Please provide the following contact information:

Player Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Parent/Guardian
Parent/Guardian
Work Phone
Cell Phone
Cell Phone
Home Phone
E-mail
Date of Birth   (12-29-98)
School Grade
Sex Male Female
   

Fee Information: $60.00 per player ( Make checks payable to UMAAU)

 Amount Enclosed: ______________________

(Mail checks to UMAAU 517 Parkview Way Newtown PA 18940)

 

I/We the parents or guardians of the above name applicant for placement on a UMAAU team, hereby give permission for the child’s participation in any and all UMAAU activities. I/We assume all risks incidental to such participation, including transportation to and from the activities. I/We do hereby waive, release, absolve, indemnify and agree to hold harmless UMAAU officers, directors, sponsors, managers, coaches, referees and persons transporting the child to and from activities from any claim arising out of injury to the child. I/We affirm that the child is in sound physical condition and that the child is covered by Health/Accident Insurance Independently. I have read the rules and the regulations of the UpperMakefield Basketball League and UpperMakefield AAU. I agree to abide by any decisions the Board of Directors may make with regard to the conduct of my family.

Parent or Guardian, by submitting this form you are agreeing to the above.

 

 

UMAAU
Copyright © 2009 UMAAU. All rights reserved.
Revised: 05/24/10