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2007 Fullcourt Press Bay Area Showcase

 

PLAYER INFORMATION FORM

(please print)

 

 

 

Name__________________________ School _______________________

 

Home Address _________________________________________________

 

City ___________________________________ Zip Code ______________

 

Phone (       ) ______________________ e-mail ______________________

 

Grade 2006-07 ________________ Height ___________ Weight _________

 

Parent/Guardian _______________________________________________

 

Please Mail $50.00 Check (Make Checks Payable to “Fullcourt Press”) and Completed Form to:

Dinos Trigonis, 3122 Theresa Street  #1, Long Beach CA  90814

 

HEALTH AND BEHAVIOR GUIDELINES AND WAIVER OF LIABILITY

 

HEALTH INSURANCE CO. ______________________________________________________

 

Policy No. _____________________________________ Group No. _____________________

 

I understand that any Fullcourt Press Bay Area Showcase participant who does not abide by the rules, regulations and policies established by the Fullcourt Press Bay Area Showcase (FPBAS) is subject to dismissal without reimbursement or recourse and I hereby waive and release the FPBAS and Woodside HS (WHS) from any and all liability for any injury or illnesses while participating in the camp.  I hereby authorize the directors of the FPBAS and WHS to act according to their best judgment in any emergency if I cannot be contacted.  I understand that each camp participant is required to have their own medical and accident insurance.  I also understand that the Fullcourt Press retains the rights to use for publicity and advertisements purposes, photographs of camp participants.

 

 

 

 

SIGNATURE OF PARENT OR GUARDIAN

 

 

 

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