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                                                                       CONTACT NAME     

 

    

                                                                                                          If you are registering a team:


                                                                                                    Team name:

                                                                                             

 

 

                                                                                                 Age group:         Sex: male     female

                                                                                                             Name of player one, two and  three

                                                                                                                       and optional substitutes:

                                                                                                  

                                                        Phone:   Second Phone:

                            Parent/guardian name(s):

 

                                                 If you are registering an individual player:
                               Your  name:

                                                 Age group:                     Sex: male     female

                                     Phone:    Second Phone:

                                      Parent/guardian name(s):
                                                     Players under 18 MUST bring a guardian to sign the waiver.

By checking the box below you agree to the following: I hereby request that my child be admitted to the Jeff Smith 3on3 tournament. I hereby authorize and direct the staff to exercise and act in their best judgment in the event any medical emergency regarding my child may arise. I also hereby confirm that my child is covered by accident insurance which provides coverage for any accidental bodily injury. By checking the box below,  I hereby agree to hold harmless   to the Jeff Smith 3 on 3. and any of its agents and/or employees in connection with any incident or occurrence arising out of my child’s enrollment in the tournament.

 

I accept: