BG Sports Registration 1

Child's Information

Child's Name

Date of birth

Grade

Gender

Shirt Size

Does your child have any experience with Basketball or Cheerleading? If so please explain.

Parent/Guardian Info

#1 Parent/Guardian Name

Would you like to be an assistant coach for your child's team?

Yes No

Email #1

This address will receive a confirmation email

Phone

Address #1

#2 Parent/Guardian Name

Would you like to be an assistant coach for your child's team? Yes No

Email #2

This address will receive a confirmation email

Phone #2

Please read carefully and check the box below to indicate your agreement .

I understand and agree that my child's participation in athletic and other activities of the program necessarily involves the risk of injury and even death from various causes. On behalf of my child I assume these risks. In consideration of the privilege of my child?s participation in the Program and on behalf of my child and me as the parent/guardian I hereby release, discharge, hold harmless and indemnify and covenant not to sue the church and all of the church?s directors, officers, elders, trustees, deacons, employees, volunteers, insurers, agents and representatives and all other persons associated with the program as to any and all claims of my child, me and other family members for personal injuries suffered by my child, property damage, medical expenses and economic loss arising directly or indirectly out of my child?s participation in the program. I understand that participation in the program may involve strenuous and prolonged physical activity. I agree that my child is healthy and able to participate in the program activities.

Yes, I agree

Media Waiver

- I hereby grant permission to Beech Grove Baptist Church to use my image/voice in any official church publications---printed or web-based---without further consideration. - I acknowledge the church's right to crop, edit, or otherwise treat any photo's recordings at its discretion. -I also acknowledge that the church may chose not to use my image or voice at this time but may do so at its own discretion at a later date. -I understand that once my image/voice is posted on Beech Grove Baptist Church's website or any of its social media profiles that it may then be downloaded by any computer user, anywhere in the world. -The church reserves the right to discontinue the use of any images/recordings at any time, without notice.

Payments

Concession Tokens:
Make concessions easier on you. For $16 for the year, your child will recieve a token at the end of each game to use at the concession stand. He/she may turn that token in to select a drink (non soda) and a food or snack item.

Sports Payment

Concession Tokens

Office Use Only

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

BG Sports Registration 1

Description

Please Fix the Following