MIME-Version: 1.0 Content-Type: multipart/related; boundary="----=_NextPart_01CAB7AF.B9C75A50" This document is a Single File Web Page, also known as a Web Archive file. If you are seeing this message, your browser or editor doesn't support Web Archive files. Please download a browser that supports Web Archive, such as Microsoft Internet Explorer. ------=_NextPart_01CAB7AF.B9C75A50 Content-Location: file:///C:/3474468D/KBASPORTSTEAMBASKETBALLLEAGUESENTRYFORM.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" KBA SPORTS TEAM BASKETBALL LEAGUES

  KBA SPORTS TEAM BASKETBALL LEAGUES=

 

Directions: All information must be valid and complete at the time = of registration. See www.playkba.com for Deadlines and Start Dates.=

 

Coach’s Name: <= span style=3D'mso-spacerun:yes'>  

Contact Phone #:

Address:

City, State, Zip Code:

Team Name:

E-mail Address: =

Circle One:   High School  /  Middle School   

League (Fees): $500.00 /8 games/ Monday-Wednesd= ay after 6p

 

Note:  No more then 14 players are allowed= on one team.

 

NAME
Please Pr= int First, Middle initial, & Last Name

 

Grade

 

Jersey #

 

School

1.

 

 

 

2.

 

 

 

3.

 

 

 

4.

 

 

 

5.

 

 

 

6.

 

 

 

7.

 

 

 

8.

 

 

 

9.

 

 

 

10.

 

 

 

 

Put additional Players on Back of Sheet (14 Limit)

.

 

 

Please read and sign:   I/WE recognize and understand that basketball is a sport involvi= ng risks not encountered in everyday play.&nb= sp; With this understanding, in consideration of the Kentucky Basketball Academy permitting myself to participate in the sports programs, I covenant= and agree to indemnify and hold harmless and do release, requite and forever discharge, Kentucky Basketball Academy, its officers, coaches, referees, employees, volunteers and other such people as are connected with the leagu= e in any capacity, for any and all damages, claims, and/or liabilities arising o= ut of any and all injury to or caused by myself. I hereby authorize any and all emergency medical treatment deemed necessary by any physician, nurse, or paramedic. A copy of this authorization shall be effective as the original.= (Signature line above.)

 =

For Office Use Only

 

 

 
 
 


 

Schedule League: _________

 

Staff Int. ________________        

 
Coach’s  S= ignature        &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;       Date

 

 

Updated: 2/28/2010

 

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