REGISTRATION Participant Name * First Name Last Name Birthdate * MM DD YYYY Grade * Current School Year 2023-2024 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th School * Level of Player Development * Introductory Foundational Advanced Performance Primary Parent Name * First Name Last Name Phone * (###) ### #### Email * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Secondary Parent / Guardian First Name Last Name Phone (###) ### #### Email Address Address 1 Address 2 City State/Province Zip/Postal Code Country Participant's Insurance Carrier: Please let us know who you are insured by. Policy Number: Medical Conditions (None, asthma, ADHD, peanut allergies, seizures, other. Please explain) How did you hear about Just Us Basketball? * Past Participant Friend Email Flyer Coach Flyer Internet Search Instagram Facebook Other Please read the following waivers and agreements carefully. They include release of liability and waiver of legal rights, and deprive you of the ability to sue certain parties. By agreeing electronically, you acknowledge that you have both read and understood all text presented to you as part of the registration process. * I agree to the Release of Liability Waiver I agree to the Active Agreement & Waiver I agree to the Refund Policy Digital Signature: Please type your signature * By signing my name below, I acknowledge that I have read and agree to all the waivers and agreements that I have selected above. Date * MM DD YYYY Thank you for joining Just Us Basketball! Please look out for a confirmation email from info@JustUsBasketball.com. Back to → Registration, Waivers & Agreement
