The Salvation Army 2019 Fall Basketball League
2019 Fall Basketball League Offers:
Best Developmental and Most Competitive League Modern Facilities Volunteer Coaching Staff Certified Referees 8 Game Regular Season Playoffs All-stars Stat tracking for every player Awards for achievement Full Uniforms All-Star Shirts Certificates for All Players Registration: July 8th- Aug 10th Divisions 5-7 Years old 8-10 Years old 11-14 Years Old
**LIMITED SPACES AVAILABLE** Regular Season: Play-Offs: All-star Game: Sept 7th – Nov 9th Nov 12th – Nov 16th Nov 23rd Evaluation Date Times August 10, 2019 August 10, 2019 August 10, 2019
9:00 am - 10:30 am 10:30 am - 12:00 pm 12:00 pm - 1:30 pm
Child plays in division based upon their age on or before Evaluation Day All players must provide a copy of birth certificate. **We now accept Credit Card, Debit Card, Cash and Money Orders** The Salvation Army Ray Robinson Oak Park Community Center (916) 469-4620 2540 Alhambra Blvd Sacramento, CA 95817 Admission to Games: $3.00 per person (5 & under free) Our campus is DRUG, ALCOHOL and WEAPON FREE.
Practice Days: Tuesday, Wednesday & Thursday Evenings!
THE SALVATION ARMY RAY ROBINSON OAK PARK COMMUNITY CENTER
2019 Fall Basketball for Boys & Girls $150.00 Per - Player (5-14-years old) 2019 Youth Sports Registration PARTICIPANT INFORMATION Divisions Circle One
7 & Under
Jersey Size: ________________ Shorts Size: _________________ 10 & Under
14 & Under
Participant’s Full Name
Date of Birth
Complete Address
City
State
Zip code
Email Address
PARENT/GUARDIAN INFORMATION Parent/Guardian name
Home Phone
Cell Phone
Emergency contact name (1)
Relationship
Phone
Emergency contact name (2)
Relationship
Phone
MEDICAL INSURANCE COVERAGE/TREATMENT INFORMATION Insurance Carrier/ Policy Number
Phone
Doctor’s Name
List any History of Allergies List Regular Medication Taken List any other Medical Conditions (physical/medical limitations) I hereby authorize my son/daughter to participate in The Salvation Army’s Youth Program. As the legal guardian of the above-named child, I agree to relieve The Salvation Army or its directors, officers, employees, agents, or other representatives from any and all liability in connection with any loss, damage, or injury arising in connection with my son/daughter’s participation in this program. I further agree to the regulations, conditions, and policies of The Salvation Army’s program and accept full financial and legal responsibility for the conduct of my son/daughter. I hereby authorize the administrators of this program reasonable and necessary emergency medical treatment for my son/daughter while he/she is participating in the program. I further agree to pay for any such reasonable and necessary medical treatment upon presentation of the medical provider’s bill or statement. I also understand that there are No REFUNDS.
Parent/Guardian Name- Please Print ______________________ Parent/Guardian Signature Office Use Only I’D #____________ Cash ____________
Date
______________________
Amount Paid_____________ Money Order______________
Application Complete
Yes
Employee Initials ____________
No
The Salvation Army Ray Robinson Oak Park Community Center ---Player Photo Release--I hereby grant The Salvation Army the absolute right and permission to copyright and/or publish or use photographic portraits or pictures of my child ______________________________, in which he/she may be included in whole or part, or composite or distorted in character or form, in conjunction with his/her name or a fictitious name, or reproductions thereof in color or otherwise, made through any media, for art, advertising, or any other lawful purpose whatsoever. I also grant The Salvation Army the same right and permission to use any statement or testimonials made by myself or my child.
_____________________________
_____________________________
Parent/Guardian Name
Parent/Guardian Signature
____________ Date
---Parent Code of Conduct--➢ I will encourage good sportsmanship by demonstrating positive support for all players, coaches, staff, and officials at all Salvation Army functions. ➢ I will place the emotional, physical, and educational well-being of all players ahead of any personal desire to win. ➢ I will remember that the game is for youth and that this league is focused on developing players in a positive and safe environment. ➢ I will ask my child/children to treat other players, coaches, fans, officials, and staff with respect regardless of race, sex, creed, or ability and will not tolerate bullying or harassment of any kind. ➢ I understand that there will not be carpools with coaches and there is no guarantee that my child will be on a coach’s team. It is my responsibility to get my child to and from practices and games. ➢ I understand that my child MUST be accompanied by an adult or the authorities will be notified. ➢ I will, at all times, remember that The Salvation Army is a Christian organization and that my family, guest(s) and I will conduct ourselves accordingly to this belief. I will handle any and all disagreements in a respectful manner, and understand that anyone who fails to comply with this code of conduct and/or the posted gym rules may be asked to leave the facility. _____________________________ Parent/Guardian Name
_____________________________ Parent/Guardian Signature
____________ Date