North Cobb Junior Warrior Registration

North Cobb Junior Warrior Registration Form

Player's Name:	First Name: Last Name:
Gender:
Date of Birth:	Month: Day: Year:
Street Address:
P. O. Box or Apt#:
City:
State:
Zip Code:
Email Address:
Home Phone:
Emergency Phone:
Medical Waiver: I recognize there are inherent risks involved in this sport activity. In consideration of the services provided, I hereby release and hold harmless North Cobb Basketball, North Cobb Tip-Off Club, and its director, coaches, employees and agents from any and all liability for injuries, including those resulting in death, and illnesses incurred while participating in the Metro League Program. I certify that my child is in good health and is able to participate in all program activities. Furthermore, in the event of an emergency requiring medical attention, I shall pay for the services rendered and authorize the above Metro League agents to seek medical treatment for my child to the best of their judgment.
Full Name of Parent / Guardian Accepting this Medical Waiver:
I Agree to the Above Medical Waiver:
Height:	Feet: Inches:
School (2010/2011):	Grade (2010/2011):