Junior Patriot Basketball League BOYS SIGNUPS: Grades 2 Through 4

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JUNIOR PATRIOT BASKETBALL LEAGUE

BOYS SIGNUPS: Grades 2 through 4



To sign up, please complete attached form below, enclose $40. Make checks payable to
Heritage Hills Boys Basketball, and return to your elementary school by September 26,
2014. Each player will receive a t-shirt to be used as his uniform. The players will keep
these at the end of the season.

Cost for 2
nd
through 4
th
Grade Leagues: $40.00


Please check the size shirt needed in the table below

Youth small _____ Adult small _____

Youth medium_____ Adult medium_____

Youth large _____ Adult large _____

Adult XL _____

Players Name __________________________________________

Parents Name __________________________________________

Address __________________________________________

Phone Number____________________ Do you text:_________

School Attending_______________________ Grade_______

Parents interested in: Coaching_______ Asst. Coaching______

EMAIL:____________________________________________________


PLEASE RETURN FORM BY SEPTEMBER 19
th
, 2014


Parent Consent, Acknowledgment and Release: I/we know of and acknowledge that my son/daughter knows of the risks involved
in athletic participation, understands that serious injury, and even death, is possible in such participation and chooses to accept any and
all responsibility for his/her safety and welfare while participating in J r. Patriot Basketball. With full understanding of the risks
involved, I/we release and hold harmless J r. Patriot Basketball of all responsibility and liability for any injury or claimresulting from
such athletic participation and agree to no legal action against J r. Patriot Basktball because of any accident or mishap involving the
athletic participation of my son/daughter.


Date:_____________ Parent/Guardian Signature: ______________________________________________________________



NOTE: Boys will be contacted first weekend in November






HERITAGE HILLS
5
th
& 6
th
Grade Boys Basketball
_______________________________________________

To sign up, please fill out the form below and enclose a $50 check payable
to Heritage Hills. A blue/white reversible jersey and matching shorts will be
provided to use as uniform. The uniforms will be turned in at the end of the
season.


Players Name: _____________________________________

Address: _____________________________________

School: _____________________________________

Phone No.: _____________________________________

Email Address: _____________________________________

Please Circle Grade: 5th 6th


Please return this form and a check for $50, payable to Heritage Hills,
and return to your school office by September 19
th
, 2014


Parent Consent, Acknowledgment and Release: I/we know of and acknowledge that my son/daughter
knows of the risks involved in athletic participation, understands that serious injury, and even death, is
possible in such participation and chooses to accept any and all responsibility for his/her safety and welfare
while participating in Jr. Patriot Basketball. With full understanding of the risks involved, I/we release and
hold harmless Jr. Patriot Basketball of all responsibility and liability for any injury or claim resulting from
such athletic participation and agree to no legal action against Jr. Patriot Basketball because of any accident
or mishap involving the athletic participation of my son/daughter.


Parents signature: _____________________________________ Date:___________________________

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