Team Name: _____________________________________________________ Grade:  ______________________________________________

Address: ____________________________________________________ City/State/Zip: _____________________________________________

Coach’s Name: ____________________________ Cell Phone #:_______________________ E-Mail:____________________________________

Asst. Coach’s Name: _______________________ Cell Phone #:_______________________E-Mail:_____________________________________

ATTENTION: NO ADDITIONS WILL BE PERMITTED AFTER THE START OF THE LEAGUE PLAY.

Uniform #

PLAYER NAME

DOB

School

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Indy Hoops, Inc. and the United States Amateur Basketball (USAB) Release of Liability and Parent/Guardian Consent:

In consideration of accepting this application and for permitting the athlete to participate in activities organized by Indy Hoops Inc. and United States Amateur Basketball (USAB) and the athlete and the parent/guardian acknowledge that such activities (games, team practice, travel tournaments and so forth) expose the athlete to risk of injury, loss or death and the athlete and parent/guardian do hereby Release, Discharge, Hold Harmless and Agree Not to Sue or Seek Recovery from Indy Hoops Inc., USAB or the directors, officers, employees, volunteers, coaches and officials of either organization, or the facility, where the activities take place, and the employees, agents and the representatives of such facilities, from any such claim arising from an injury, loss or death of the athlete from such activity.

This release of liability includes, but limited to, the 2019 Indy Hoops Leagues, Tournaments and USAB Tournaments.