House Team Registration


______  I would like to be placed on a team for _________________________ program.


______  I have ______ players and we would like to be placed on the same team for the ____________________________

            program.  I will have register individually but here are the players names: __________________________________

          ______________________________________________________________________________________________

We will do our best to put you in touch with a coach in need of a player or players.  We are always looking for good coaches to help after teams are formed.  There is no guarantee that you be placed on a team before the league or tournament starts.

Players Name ______________________________________________ Date of Birth: _______________

Address _________________________________ City ___________________ St _____Zip __________

Phone (Home) _________________________ Email ________________________________ (parents or yours)
                                                           Adult
Current Grade: _______ Ht. _____  T Shirt Size: _________  Mom/Dad Name ______________________

PAYMENT Information: Payment of the team or individual must be done at the time it is mailed in of by attaching credit card information below.  There is a $3 charge per transaction added for credit card processing.  Your payment will not be processed until you are placed on a team.

______ Check via Mail                 ______ Money Order
 
Credit Card (Master Card of Visa)   Credit Card No. __________________________  Expiration: ________

Name on It ________________________  Credit Card Signature: _________________________________ 


Permission and Liability Waiver

I give permission to my son/daughter to participate in the activity at  Hoop City or event sponsored by Hoop City.  I further understand that participation is such activities may cause injury to my son/daughter just by the nature of the activity.  I take full responsibility for any injuries suffered by my son/daughter and will hold Hoop City Basketball, LLC, Hoop City Jenison Partnership, the partners of such, and the staff of Hoop City harmless for any injury, loss or damage.

I further assure that my son/daughter has no health problems that would prevent them from full participation in the activities involved in the event they are registering for.  I am solely responsible for their safety and have fully inspected the facilities used by Hoop City to host such activities.   I take responsibility for monitoring their physical condition during such activities, even though I might not be in attendance.

I fully release Hoop City Basketball, LLC, Hoop City Jenison Partnership, its sponsors, staff, instructors, officers, agents, partners and any  representatives of  any liability, loss, or legal action and further agree that this applies to my heirs, assigns and persons acting on my behalf, including a coach, parent, or guardian.

I have checked the capabilities and background of the individuals participating as coaches or instructors of the activities my son/daughter have participated in and fully release Hoop City Basketball, LLC, Hoop City Jenison Partnership, its sponsors, staff , instructors, officers, agents, partners and any  representatives of  any liability, loss, or legal action associated with that coach, coaches, or instructors.

I have read and fully understand the above Permission and Liability Waiver and agree to abide by it.

Parent/guardian Signature: _______________________________________  Date: _________________________


Hoop City -   
Mailing: PO Box 68544,  Grand Rapids, MI 49506
616-957-HOOP (4667) - HoopCity2@aol.com