AUBURNDALE YOUTH BASKETBALL LEAGUE, INC.             

P. O. Box 1732              

Auburndale, FL 33823              

ONLINE REGISTRATION FORM


***Registration for 2012/2013 Now Available***


(***Player Information***) Player Full Name:                     Player Birth Date (MM/DD/YYYY):

Parent's Name:         Address:             

City:     Zip:

                                                                                                                         
Primary Phone:                 Emergency Phone:                

School:                 Grade:

Valid E-mail       This must be a valid e-mail address of the parent registering the child.
Address:

Gender:       Shirt Size:       Would You Like To Help:      

If you know someone who would like to sponsor a team please call Leslie Fuhrman @ 863-661-2871 or e-mail auburndaleyouthbasketball@live.com

PARENT/GUARDIAN WAIVER/RELEASE STATEMENT

Parent or Guardian’s signature giving the above named person permission to play in the Auburndale Youth Basketball League and/or AYBL HOOPS and/or AHS Athletic Boosters, Inc/Basketball and that you do hereby agree to hold harmless the City of Auburndale, the Auburndale Youth Basketball League, Inc. and the Board of Directors responsible for any accident or injury that might be incurred as a result of participation in same whether in a game, at practice or during travel. I further agree that the immediate supervisor is authorized in my name, to have administered emergency medical aid and further that he/she may arrange for transportation to either the doctor’s office or hospital as may be required I understand that my behavior during practice, games, tournaments, etc. is expected to be of a mature nature keeping in mind that this is youth sports, not the NBA/WNBA. I will act accordingly as well as my child. I certify that by submitting this online application that I am providing full agreement to all of these waiver terms and conditions.

                                                  Check Here To Confirm That You Read The Waiver And Agree With The Terms


Youth Basketball Camp with AHS High School Coach and players, December 8, 2012 9:00-1:00, cost is $10
To confirm that you wish to sign the player up for the youth basketball camp, please select the checkbox
(***Click Paypal Button To Process Payment***)
Online Registration Fee is $60.00:





REMEMBER, THIS IS YOUTH SPORTS!


www.auburndaleyouthbasketball.com
auburndaleyouthbasketball@live.com

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