Registration Form - Blazers Fall 2017 Boys AAU Basketball

Please fill out the registration information below. NOTE: In addition to providing some information about the player/family and completing the waiver, we also ask that you tentatively provide some other information (ex: desired uniform numbers) so that, for players that join a team, we won't need to come back again and ask you to fill out a separate form and waiver (this also helps us expedite the process of scheduling practices and getting uniforms ordered as we don't have much time after tryouts to do all of this!).

Once you complete this form, you will be directed to our online Store where you can pay the tryout fee with a credit card. Please note that the tryout fee covers participation in all tryout sessions. Thank You!

Tryout Times Updated as of Aug 18th:
Incoming Grade 3 & 4: 5:00 - 6:30
Incoming Grade 5: 5:45 - 7:15
Incoming Grade 6: 6:30 - 8:00
Incoming Grade 7: 7:45 - 9:30
Incoming Grade 8: 7:15 - 8:45
Incoming Grade 9: 7:15 - 8:45

Question Title

* 1. Player Information:

Player First Name: *

Player Last Name: *

DOB (MM/DD/YYYY): *

Allergies or other Physical/Medical Concerns:

Medical Insurance: *

Policy #: *

Question Title

* 2. The Player will be in what Grade in September?

Other (please specify)

Question Title

* 3. The Player is from what town?

Question Title

* 4. Parent1 Information

First Name: *

Last Name: *

Address: *

Address 2:

City/Town: *

State: *

ZIP: *

Cell Phone: *

Email Address: *

Question Title

* 5. Parent2 or Other Emergency Contact

First Name:

Last Name:

Cell Phone:

Email Address:

Question Title

* 6. If your child is offered a spot on a Blazers team, what level of commitment can you and he make to AAU Basketball this coming season? Please consider the options below carefully - we need to ensure teams have enough fully committed players, so those players who are fully committed will receive more consideration when offers are made.

1) Fully Committed: Blazers Basketball is his #1 Priority this coming season: The player can commit to making it to all Blazers practices and games regardless of when they might be (i.e., practices and games for other sports will not impact his/her ability to make Blazers practices and games).

2) Mostly Committed but he/she does have another Sport this coming season: He plays another sport and wants to also be able to participate in that other sport. He/she will commit to making it to all of the Blazers team practices (1 per week) until at least October 13th. He/she plans to make at least 60% of the Blazers games. When game conflicts arise, we intend to share the priority with the other sport (i.e., sometimes missing the Blazers game and sometimes missing the other game). We understand that we need to request and be granted permission to miss games (so the coach can reasonable balance these requests while ensuring the team has enough players to avoid a forfeit).

3) Blazers Basketball is his 2nd Priority this coming season: Same as above regarding practices, but he/she will only make a Blazers games on if they don't conflict with the other sport.

4) Practice Player Only: His schedule will be very busy so he won't be able to make Blazers games. Assuming the Blazers practices do not conflict with practices for other sports, he would like to be considered for a role as a practice player, and if chosen will commit to make it to all Blazers practices. We understand if you need some time to sort out your schedule for the other sport before accepting a role as a practice player.

Comments regarding his/her schedule or level of commitment. Please be sure to include any information about other sports that take priority this coming season and when the practices/games are (ex: Football - practices are on Tues/Thurs, walkthroughs Sat AM, Games Sunday early afternoon).

Question Title

* 7. If you are registering a new player, please specify his/her top 5 uniform numbers (in order of preference). If you are going to include popular numbers like 23, 30, 33, 35, etc. feel free to provide more than 5 options. If none of the numbers you provide are available then we will assign a random number, so feel free to provide as many numbers as you like. Note that you may include options that use the numbers 6-9.

Question Title

* 8. Name of School Attending (needed for AAU Roster)

Question Title

* 9. Terms and Conditions:
Waiver: As the parent or legal guardian of the participant named above, I hereby give my full consent and approval for my child to participate in the tryout process, and if selected for a team, to join and participate on a team (collectively, the "Program"). I understand that there are certain risks of injury inherent in the practice and play of this sport, and I am willing to assume these risks on behalf of my child. I hereby certify that my child is fully capable of participating in the designated sport and that my child is healthy and has no physical or mental disabilities or infirmities that would restrict full participation in these activities, except as listed above. I understand that my medical insurance is expected to cover the cost of my child’s injuries. I grant permission to the coaches or volunteers involved with this Program to seek medical care in the event I cannot be reached. I agree not to hold Alpha Youth Sports, or any of the parties/facilities connected with this Program, responsible for any injury or accident that may occur during the program, whether the result of negligence or any other cause.

Video Release: For good and valuable consideration, the receipt of which is hereby acknowledged, I hereby consent to the photographing of my child and the recording of my child's voice by Alpha Youth Sports, Inc. (“AYS”) during this Program. I understand that the term "photograph" as used herein encompasses both still photographs and motion picture footage. Provided that AYS does not identify my child's last name, nor town of residence, in these photographs or recordings, I irrevocably consent to the use of these photographs and/or recordings singularly or in conjunction with other photographs and/or recordings for advertising, publicity, commercial or other business purposes, as well as to the reproduction and/or authorization by AYS to reproduce and use said photographs and recordings of my child's voice, for use in all domestic and foreign markets. I hereby release AYS, and any of its associated or affiliated companies, their directors, officers, agents, employees and customers, and appointed advertising agencies or other assigned third parties, their directors, officers, agents and employees from all claims of every kind on account of such use.

Program Dismissal: I understand that if my child becomes a discipline problem, he/she will be dismissed from the Program, and that no money will be refunded.

Do you acknowledge your understanding and acceptance of these Terms and Conditions?

Yes