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Every Player Receives:
Plus …
All
Star Uniform Top
Equal Playing Time...
Regardless of Skill Level
All
Star T-Shirt
Individual and Team Instruction
8
Regular Season
games
Weekly Practices
Tons of Fun! PLUS MUCH MORE!
Participation
Trophies
K - 2nd Grade $70
3rd - 6th Grade $80
Includes: 8 regular season games, weekly practices, uniform top,
post-season Awards Banquet, and a few surprises.
Early Bird DEADLINE IS OCT. 19
Early Bird registrations will receive a FREE Super Slam Basketball Set
Registration Form and Payment must be received by deadline!
(While Supplies Last)
REGISTRATION INFORMATION
Registrations are accepted on a first come, first serve basis!
Any registration forms received after the deadline are not guaranteed
placement on a team. However, the All Star Leadership Team will
work hard to place every child on an age-appropriate team.
LEAGUE SCHEDULE 2010-11
Practices begin in November
League games begin Saturday, December 18th
Last game is Saturday, February 19th (Weather Permitting)
HOW DO I SIGN UP?
ALL STAR BASKETBALL
DELIVER or MAIL your Registration Fee and
Form to the church listed below. Make checks
payable to Parkview Baptist Church.
2010-2011 REGISTRATION FORM
Last Name:
Father’s Name:
First Name:
Work Phone:
Address:
Other Phone:
ALL STAR BASKETBALL C/O:
City:
Parkview Baptist Church
5805 S. Sheridan Rd.
Tulsa, OK 74145
Zip:
Mother’s Name:
Home Phone:
Work Phone:
Other Phone:
Other Phone:
Email:
Melinda Loftis at
492-4545 or
[email protected]
Emergency Contact:
Gender: M
F
Date of Birth:
Phone:
Grade: K 1 2 3 4 5 6
My Dad / Mom would be interested in helping as:
School:
Coach:
Church (if any):
Assistant Coach:
REGISTRATION INFORMATION
Team Parent:
I have  have not  played in an organized basketball league.
All Star is for boys & girls grades K-6
K - 2nd $70
3rd - 6th $80
Includes: 8 regular season games
weekly practices, uniform top,
post-season Awards Banquet,
and a few surprises.
UNIFORM INFORMATION: (Circle size needed.)
Jersey
YS
YM
YL
AS
AM
AL
AXL
T-shirt will be same size as Uniform Top.
Early Bird Deadline is October 19
Uniform sizing done by appointment only at practice church.
Player receives Super Slam Basketball Set
Registration Form and Money
must be received by deadline!
How did you hear about All Star Basketball:
____ Brochure from school
____ From an All Star Family
____ Home Church
____ Other: ______________________________
I would like to play with______________________
NOTE: No preformed/competitive teams allowed.
EMERGENCY MEDICAL RELEASE, AND WAIVER (To be completed by parent/legal guardian)
REGISTRATION DEADLINE IS OCT. 27
Registrations are accepted on a
first come, first serve basis!
Any registration forms received
after the deadline are not guaranteed
placement on a team.
However, the All Star Leadership Team will
work hard to place every child on an
age-appropriate team.
I/we the parent and/or legal guardian of (full legal name)
, hereby acknowledge that said minor is presently
under my/our care, custody, and control. I/We hereby give my/our child the said permission to participate in the 2009-20010 All Star Basketball League. I the parent/guardian of
the above named player acknowledge that participation in athletic events necessarily involves risk of physical injury. I further acknowledge that All Star Basketball relies on
volunteers/amateurs as coaches, officials, and scorekeepers. I hereby release, discharge, and hold harmless the All Star Basketball League (and/or Parkview Baptist Church,
South Tulsa Baptist Church), its employees, volunteers, and other representatives from any claims arising out of or relating to any physical injury that may result to said individual
while participating in ANY All Star Basketball League sponsored events. In the event that there arises an emergency, necessitating medical, surgical or dental attention, I/We
hereby consent to give my/our permission to the All Star Staff or its representatives, or any attending physician or dentist to make such decisions and to perform such medical
treatments and/or surgery upon said minor which may in their sole discretion be necessary and proper under the circumstances. Further, we acknowledge and consent to have
our child photographed and videotaped for the purposes of All Star and/or Parkview Baptist Church and/or South Tulsa Baptist Church advertising and promotion. The medical
release will remain effective through March 10, 2011.
Furthermore I have read and understand the Parents Code of Conduct and will adhere to the code at all times. I hereby release Christian Basketball Youth Association (CBYA),
Access Sports, Shock Basketball Academy, or any other associates affiliated with the Christian Basketball Youth Association (CBYA) from any liability as a result of participation in
their programs. I also understand that I may receive from the CBYA during the year promotions from associates affiliated with the CBYA.
Signature of Parent/Guardian:
Date:
LEAGUE SCHEDULE 2010-11
FOR OFFICE USE ONLY
Practices begin in November
League games begin Saturday, Dec. 18
Last game is Sat., February 19
(Weather Permitting)
Payment Type:
Player Fee $
Check (Check# _________) Amount: $
— Amount Paid $
Team Assignment:
= Balance Due $
Coach:
-or-
Cash
Amount: $
Registration Completed: ___/___/___
Team Parent: