Over 40 Basketball League
Name
_ DOB
Address
Phone#
Age _____
City
Zip
_____ ________Email
______
_____________
Important Medical Information:
___________________
$40 Member/$50 Non-Member
Shirt Size (circle one): S
M
L
XL
XXL
In an attempt to create even, fair and competitive teams please provide the following.
Height:_______
Estimated Skill Level (circle one): (low) 1
2
3
4
5
6
7
8
9
10 (high)
▪ Registration ends Jan. 9th ▪ Must be at least age 40 by end of March 2016
▪ Teams Assigned & Colored T-Shirts Provided ▪ Games will begin 6:00pm January 10th and be played every
Tuesday
I recognize that participation in YMCA activities may expose myself to some risk of injury. I agree to hold the YMCA harmless from
any claims for damage to any property or injury to persons which may occur through participation in any activity at the YMCA or its
programs. I have read and understand the above information.
Signature
Date
Over 40 Basketball League
Name
_ DOB
Address
Phone#
Age _____
City
Zip
_____ ________Email
_____________
Important Medical Information:
$40 Member/$50 Non-Member
______
___________________
Shirt Size (circle one): S
M
L
XL
XXL
In an attempt to create even, fair and competitive teams please provide the following.
Height:_______
Estimated Skill Level (circle one): (low) 1
2
3
4
5
6
7
8
9
10 (high)
▪ Registration ends Jan. 9th ▪ Must be at least age 40 by end of March 2016
▪ Teams Assigned & Colored T-Shirts Provided ▪ Games will begin 6:00pm January 10th and be played every
Tuesday
I recognize that participation in YMCA activities may expose myself to some risk of injury. I agree to hold the YMCA harmless from
any claims for damage to any property or injury to persons which may occur through participation in any activity at the YMCA or its
programs. I have read and understand the above information.
Signature
Date