Watauga Warriors Travel Basketball

Registration, Waiver and Release Form

2017-2018

Registration Fee: Grades 6-8$325 per chilD, ($25 discount per additional child) Payments shall be made by check, payable to “Watauga Warriors” and delivered at walk-in registration or mailed to 1055 Hunting Hills Ln., Boone, NC 28607. The registration fee is non-refundable, unless your child is not selected to play on a team.

6rd – 8th Grade Registration Deadline: The Registration Fee must be paid in full within 2 weeks of team selection. Contact Brittany Bolick or Kim Pryor if a payment plan needs to be Set Up. Your child will not be permitted to try-out or practice with his or her team until you have completed and submitted this Registration, Waiver and Release Form. Please refer to the Watauga Warriors Travel Basketball website ( for information on raising money through sponsors to offset your individual cost.

Last Name / Preferred Phone
Child 1 First Name / Age / Birth date / School Attending
Child 1 Please List Any Pertinent Medical Information (Allergies, Medicines, etc.) / Age Group (circle one):
Grade 3, Grade 4, Grade 5, Grade 6, Grade 7, Grade 8
Child 2 First Name / Age / Birth date / School Attending
Child 2 Please List Any Pertinent Medical Information (Allergies, Medicines, etc.) / Age Group (circle one):
Grade 3, Grade 4, Grade 5, Grade 6, Grade 7, Grade 8
Street Address / City / Zip
Medical Insurance Carrier / Medical Insurance ID#
Father’s /Guardian Name / Father’s/Guardian cell phone / Father’s/Guardian email
Mother’s/Guardian Name / Mother’s/Guardian cell phone / Mother’s/Guardian email
Emergency Contact / Emergency Contact Relationship / Emergency Contact Phone
Physician’s Name / Physician’s Phone
Jersey Size (Circle one per registered player)
Youth Small Youth Med Youth Large Adult Small Adult Med Adult Large Adult XL / Uniform Shorts Size (Circle one)
YS YM YL AS AM AL AXL
Shirt Size (circle one)
Youth Small Youth Med Youth Large Adult Small Adult Med Adult Large Adult XL / (indicate top 3 in order of preference)
Preferred Jersey Numbers: ______, ______, ______

Waivers, Acknowledgments and Release for Participation:

In consideration of my child(ren)’s participation in the Watauga Warriors basketball programs and activities, I hereby release and discharge,and agree toindemnify and hold harmless, the Watauga Warriors basketball club, its directors, officers, coaches and volunteers, the Town of Boone, and the Watauga School District from any and all loss, claim, personal injury, damage or liability whatsoever resulting from or in any way related tothe participation of my child(ren) in the Watauga WarriorsTravel Basketball programs or activities. I herebyexpressly and voluntarily assume all risks of any liability for injuries which may be sustained by me or my minor child(ren), whether caused by negligence or otherwise. Neither I nor my child(ren) suffers from any physical impairments or limitations that would prevent them from participating in any Watauga WarriorsBasketball programs or activities. In case of a medical emergency concerning my child(ren), at a time when I or the emergency contact listed aboveis not present, I authorize duly licensed health care professionals to perform any necessary x-ray examination, anesthetic, medical or surgical diagnosis or treatment, or hospital care of the above-named child(ren). As the parent or legal guardian of the above-named child(ren), I accept full financial responsibility for any such treatment, including the cost of any transportation related thereto. I hereby authorize Watauga Warriors Basketball Club to use my child(ren)'s name(s) and/or picture(s) in connection with the promotion or undertaking of any Watauga Warriors Basketball programs or activities, including without limitation on the Watauga Warriors Travel Basketball website ( in game programs, and in general marketing, promotional and advertising materials. I agree to promote good sportsmanship and fair competition at all times and to obey the rules and decisions of Watauga Warriors basketball club, its directors, officers and coaches. I agree to reimburse the Watauga WarriorsTravel basketball club upon demand for any amounts which Watauga Warriors Basketball may be assessed, fined, penalized or otherwise charged related to my behavior or actions or the behavior or actions of my child(ren) or guests, including without limitation any fines related to my or my child(ren)’s or my guest’s removal or ejection from any facility for any reason whatsoever. The player registering is making a commitment to the Watauga Warriors Travel Basketball organization and the team he/she is selected for to maintain an active role on and for that team.

______Signature of Parent or Guardian Date

______

Signature of Athlete Date