IF YOU GET ERRORS:
Please make sure you filled out ALL info
Or feel free to come into the Youth Center (see details at bottom of page)
STEP 1 of 2 - APPLICATION
(after submitting this application, you will be directed to a page to pay via credit/debit card using PayPal. If you wish not to pay by card, please come into the Youth Center, hours are listed at the bottom of the page, and DO NOT submit an application yet.)
Be sure to list ALL details requested
Please double check your child's jersey size!
(To reorder your jersey, it will cost you $30.00!)
Please include all medical details that are important to playing basketball or exercise in general.
May we use your image(s), or those of your child(ren) if under 18, in publicity material produced by the Town of Griswold, including printed publications, videos and our website?
Waiver of Liability and Hold Harmless Agreement
I, for myself and participant(s) named below hereby WAIVE, RELEASE, AND HOLD HARMLESS the Town of Griswold, their owners, affiliates, directors, coaches, shareholders, officers, members, agents, employees, landlords, other participants, sponsoring agents and all other persons or entities acting on their behalf, from and against any and all claims, liability, damages, cost or expenses (including attorney’s fees) arising out of or related to our participation or use of the facility. I am aware that by signing this agreement, I assume all risks and waive and release all substantial rights that I may have and possess. I give permission for my child to participate in Griswold Youth Basketball League. I understand that my child will be under the direct supervision of Town of Griswold Staff while participating in program activities. My child agrees to abide by all established rules of conduct and knows that failure to follow said rules could result in possible removal from the program. I further give permission for Town of Griswold personnel to provide first aid for the child named above and to take appropriate measures including contacting emergency medical services. I also give permission for necessary medical services to be provided under the general supervision and on the advice of a licensed physician if my child should become ill or injured during program activities. It is understood that conscientious effort will be made to notify me before such action is taken. I hereby relieve the Town of Griswold staff and its representatives of all responsibility and consequences that might arise as a result of this treatment and/or programming. I agree to accept any and all financial responsibility as a result of such treatment.
I have read the terms of the Release & Consent form and have explained to the child named above. My typed name below signifies my willingness to abide by the terms set forth herein.
Feel free to list more than one phone number.
All home addresses are confirmed by the Town Hall
Please be sure your phone number and email are correct. If you change either, let us know ASAP to update your records.
DEADLINE TO SIGN UP:
WEDNESDAY, NOV. 29th
(no applications taken in at the player's clinic)
SIGN UP & PAY TOGETHER in person?
Griswold Youth Center - M/F from 1:00 to 4:00 pm
(Closed Thanksgiving Day and black Friday)
(Cannot sign up without full payment)