TEAM NAME___________________

Sat. March 28th, 2015

Cortland County Office
Bldg. Gym
REGISTRATION FORM
Early bird registration fee by March 1st $20 per player
Registration fee if received after March 1st $25 per player
Final registration deadline is March 14th
(cash or checks payable to the American Cancer Society)
DIVISION: (PLEASE CIRCLE ONE)
GIRLS 10-11yrs. 12-13yrs. 14-15yrs. 16-17yrs.
BOYS

ADULT 18+

10-11yrs. 12-13yrs. 14-15yrs. 16-17yrs.

Each player must complete a separate registration form

PLAYER INFORMATION:
Player Name:

Player Registration Fee $20/$25

____cash ____check

Phone number:

Date of birth:

Age:

Team name:

Email:

Other members of your team (all teams must be made up of 4 players for substitutions/injury)
1.____________________ 2._______________________ 3._______________________
SPORTSMANSHIP PLEDGE
By completing this form, all players accept responsibility for their conduct at the
Hoops for Hope Tournament. The event reserves the right to disqualify and
eject any individuals and/or teams that behave in an unsportsmanlike manner.
DISCLAIMER AND PLAYERS ASSUMPTION OF RISK
I hereby release and discharge the organizers of this tournament and the County office bldg. gym from
all actions, suits, and demands whatsoever in law or equity, including but not limited to those relating to
the risk of personal injury or loss of personal property by theft or otherwise sustained by me or my
minor child during the tournament.
Player signature:

Parent/Guardian signature: