Dyckman Youth Enterprises isproud to present the 2013AAU Basketball Program Tryouts. We are an organization that unites sports and academics.

Our mission is to offer a program that promotes studentathletes will receive basketball trainingin a structured, disciplined and enjoyable environment

With the growing success of the Dyckman Basketball Tournament, Our AAU Program fits theneed to develop and instruct current and prospective ball players by keeping the competitiveness and intensity at a high level. Many of our participants have gained the necessary proficiencyto play on their high school,college and professional teams

Instructed by a variety ofcertified coaches and trainers. The try-outs are scheduled during the weekends, not to interfere with the student-athlete’s daily routines. You will have the opportunity to travel to local and Out of state tournaments to compete against some of the top AAU programs in the country.All our athletes are required to maintain a positive attitude and show good sportsmanship at all times.

AllStaff are CPR & First Aid Certified

Ifyou should have any additional questions or would like to find out how you can get involved, feel free to contact

KenStevens:

Ralph Pena:

Isaiah Brown:

Sharon Bond:

Star Jones:

Dyckman Basketball AAU Program

Try Out Registration Sheet

Name: Phone #:

Address:

School: Class: ______

DOB: AGE:_____

E-mail:

Emergency Contact

Name:

Phone Number:E-mail:

Are you a new participant to the Dyckman Program? Yes orNo

If your answer is No who was your Coach? And what age group did you play for?

______Coach’s Name Age Group: ______

Athletic Department

What position do you play? point guardshooting guard small forward

Power forwardCenter

Strengths at this position

Explain

Weakness at this position

Explain:

Whyare you trying out for this team?

Gain ExposureGain ExperienceStay in Shape Just to Play Ball

Other______

Please print out this form and complete information

Athlete Waiver/Release Form (“Agreement”)

I, the undersigned, ______, acknowledge that I am receiving valuable experience by my involvement with the Dyckman Basketball Tournament In consideration thereof, I hereby grant permission for the player to play, compete and otherwise participate in the Dyckman Basketball Tournaments games, tournaments, clinics, camps, and all means including private, public and commercial activates sponsored by the Dyckman Basketball Tournament

I recognize the fact that basketball is a contact sport and that serious injuries can and do occur. I accept full responsibility for any injuries that may occur to myself as a result of me participating in the Dyckman Basketball Tournament. I waive any and all liability against the Dyckman Basketball Tournament / Staff, all School Districts, recreation centers, athletic facilities and any and all staff, volunteers, and anyone else helping or sponsoring this event, and herby release and discharge the same, from any claim, loss, injury, cost, damage and expense incurred/sustained, by or on behalf of my participation in the program.

I, the undersigned, ______, hereby grant permission for the Dyckman Basketball Tournament to authorize medical or dental treatment for the player by any qualified physician/dentist or other trained medical personnel. Also, permission to use photos/videos for advertising and publicity.

______

Division Team Name

______

Player Name Printed Player Signature Date

______

Parent/Guardian Name Printed Parent/Guardian SignatureDate

______

Address City & State Zip

______

Home PhoneCell Phone

Every Player and Parent need to fill-out one of these forms

Dyckman Youth Enterprises

4768 Broadway #903

New York, NY 10034