Kettering Basketball Club Consent Form
PLEASE READ AND SIGN BOTH THE MEDICAL RELEASE AND FAMILY MEMBERSHIP AGREEMENT BELOW
Release Agreement for Minor
I, the undersigned, being the parent and/or legal guardian of Sloan Ancheta , a player in the Kettering Basketball Club who is a minor, do hereby understand fully the risks associated with participating in this activity and in consideration of accepting my child for the Kettering Basketball Club and it's programs, do hereby release, discharge and/or otherwise indemnify the Kettering Basketball Club, all it's administrators, coaches, volunteers and associated personnel, against any claim by or on behalf of my child as a result of his/her participation in the Kettering Basketball Club, including being transported to or from Club activities for which I gave verbal or written authorization.
Furthermore, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well being of my dependent named above.
Finally, in my absence I, the undersigned, as the parent and / or legal guardian of my child, do hereby give my consent for the transport of the above named minor, for the purposes of Medical Treatment, and / or Scheduled Practices and / or Games; by his/her coaches.
Mother: Whitney Ancheta Father: Micah Ancheta or Guardian: _______________
--> Signature ______________________________________________ Date _______________
PHONE: DAD 9377919460 MOM 9477919459
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Family Membership Agreement
I, the undersigned, being the parent and/or legal guardian of Sloan Ancheta fully understand that the following seven items are conditions of my child be accepted into and participating in the Future Firebirds Basketball Program:
1. I must maintain his/her entire uniform throughout the entire season and realize that if I lose or destroy any part of it, that I must immediately pay $25 per individual item to replace it.
2. I am financially responsible for any bank charges that the Club might incur because of my giving the Club a check that does not immediately clear my account..
3. I realize that regardless of how many games or minutes my son/daughter actually participates in or his/her team plays; there will be absolutely NO refunds of any portion of the player participation fee.
4. While at any Club function (games, practices, meetings, etc.) our entire family unit must always conduct ourselves in a manner consistent with the club's spirit of integrity, decency, and fair play and in conformance with the Metro Behavioral Code of Conduct that each player and parent is required to read and sign..
5. I understand that none of my other children may be in the school building during my child's practices and young children must be supervised at games.
6. I understand and accept that the Club has no tolerance for parental misbehavior. If a player has an adult relative ejected from a game by an official, that adult will no longer be permitted to attend home games. On the 2nd family offense, player will be expelled from the Club – no refunds will be made. Also, if a relative is found "coaching" from the sidelines, they will be asked to leave the game. Please allow the coaches to be the only voice of instruction during the games.
Mother: Whitney Ancheta Father: Micah Ancheta or Guardian: _______________
--> Signature ______________________________________________ Date _______________
3rd Grade Boys Blue
Kettering Basketball Club Consent Form
PLEASE READ AND SIGN BOTH THE MEDICAL RELEASE AND FAMILY MEMBERSHIP AGREEMENT BELOW
Release Agreement for Minor
I, the undersigned, being the parent and/or legal guardian of Quentin Berger , a player in the Kettering Basketball Club who is a minor, do hereby understand fully the risks associated with participating in this activity and in consideration of accepting my child for the Kettering Basketball Club and it's programs, do hereby release, discharge and/or otherwise indemnify the Kettering Basketball Club, all it's administrators, coaches, volunteers and associated personnel, against any claim by or on behalf of my child as a result of his/her participation in the Kettering Basketball Club, including being transported to or from Club activities for which I gave verbal or written authorization.
Furthermore, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well being of my dependent named above.
Finally, in my absence I, the undersigned, as the parent and / or legal guardian of my child, do hereby give my consent for the transport of the above named minor, for the purposes of Medical Treatment, and / or Scheduled Practices and / or Games; by his/her coaches.
Mother: Dana Berger Father: or Guardian: _______________
--> Signature ______________________________________________ Date _______________
PHONE: DAD MOM 937-471-2124
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Family Membership Agreement
I, the undersigned, being the parent and/or legal guardian of Quentin Berger fully understand that the following seven items are conditions of my child be accepted into and participating in the Future Firebirds Basketball Program:
1. I must maintain his/her entire uniform throughout the entire season and realize that if I lose or destroy any part of it, that I must immediately pay $25 per individual item to replace it.
2. I am financially responsible for any bank charges that the Club might incur because of my giving the Club a check that does not immediately clear my account..
3. I realize that regardless of how many games or minutes my son/daughter actually participates in or his/her team plays; there will be absolutely NO refunds of any portion of the player participation fee.
4. While at any Club function (games, practices, meetings, etc.) our entire family unit must always conduct ourselves in a manner consistent with the club's spirit of integrity, decency, and fair play and in conformance with the Metro Behavioral Code of Conduct that each player and parent is required to read and sign..
5. I understand that none of my other children may be in the school building during my child's practices and young children must be supervised at games.
6. I understand and accept that the Club has no tolerance for parental misbehavior. If a player has an adult relative ejected from a game by an official, that adult will no longer be permitted to attend home games. On the 2nd family offense, player will be expelled from the Club – no refunds will be made. Also, if a relative is found "coaching" from the sidelines, they will be asked to leave the game. Please allow the coaches to be the only voice of instruction during the games.
Mother: Dana Berger Father: or Guardian: _______________
--> Signature ______________________________________________ Date _______________
3rd Grade Boys Blue
Kettering Basketball Club Consent Form
PLEASE READ AND SIGN BOTH THE MEDICAL RELEASE AND FAMILY MEMBERSHIP AGREEMENT BELOW
Release Agreement for Minor
I, the undersigned, being the parent and/or legal guardian of George Borland , a player in the Kettering Basketball Club who is a minor, do hereby understand fully the risks associated with participating in this activity and in consideration of accepting my child for the Kettering Basketball Club and it's programs, do hereby release, discharge and/or otherwise indemnify the Kettering Basketball Club, all it's administrators, coaches, volunteers and associated personnel, against any claim by or on behalf of my child as a result of his/her participation in the Kettering Basketball Club, including being transported to or from Club activities for which I gave verbal or written authorization.
Furthermore, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well being of my dependent named above.
Finally, in my absence I, the undersigned, as the parent and / or legal guardian of my child, do hereby give my consent for the transport of the above named minor, for the purposes of Medical Treatment, and / or Scheduled Practices and / or Games; by his/her coaches.
Mother: Beth Borland Father: Mark Borland or Guardian: _______________
--> Signature ______________________________________________ Date _______________
PHONE: DAD 9374696409 MOM 9376728078
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Family Membership Agreement
I, the undersigned, being the parent and/or legal guardian of George Borland fully understand that the following seven items are conditions of my child be accepted into and participating in the Future Firebirds Basketball Program:
1. I must maintain his/her entire uniform throughout the entire season and realize that if I lose or destroy any part of it, that I must immediately pay $25 per individual item to replace it.
2. I am financially responsible for any bank charges that the Club might incur because of my giving the Club a check that does not immediately clear my account..
3. I realize that regardless of how many games or minutes my son/daughter actually participates in or his/her team plays; there will be absolutely NO refunds of any portion of the player participation fee.
4. While at any Club function (games, practices, meetings, etc.) our entire family unit must always conduct ourselves in a manner consistent with the club's spirit of integrity, decency, and fair play and in conformance with the Metro Behavioral Code of Conduct that each player and parent is required to read and sign..
5. I understand that none of my other children may be in the school building during my child's practices and young children must be supervised at games.
6. I understand and accept that the Club has no tolerance for parental misbehavior. If a player has an adult relative ejected from a game by an official, that adult will no longer be permitted to attend home games. On the 2nd family offense, player will be expelled from the Club – no refunds will be made. Also, if a relative is found "coaching" from the sidelines, they will be asked to leave the game. Please allow the coaches to be the only voice of instruction during the games.
Mother: Beth Borland Father: Mark Borland or Guardian: _______________
--> Signature ______________________________________________ Date _______________
3rd Grade Boys Blue
Kettering Basketball Club Consent Form
PLEASE READ AND SIGN BOTH THE MEDICAL RELEASE AND FAMILY MEMBERSHIP AGREEMENT BELOW
Release Agreement for Minor
I, the undersigned, being the parent and/or legal guardian of Whitaker Garringer , a player in the Kettering Basketball Club who is a minor, do hereby understand fully the risks associated with participating in this activity and in consideration of accepting my child for the Kettering Basketball Club and it's programs, do hereby release, discharge and/or otherwise indemnify the Kettering Basketball Club, all it's administrators, coaches, volunteers and associated personnel, against any claim by or on behalf of my child as a result of his/her participation in the Kettering Basketball Club, including being transported to or from Club activities for which I gave verbal or written authorization.
Furthermore, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well being of my dependent named above.
Finally, in my absence I, the undersigned, as the parent and / or legal guardian of my child, do hereby give my consent for the transport of the above named minor, for the purposes of Medical Treatment, and / or Scheduled Practices and / or Games; by his/her coaches.
Mother: Courtney Garringer Father: Adam Garringer or Guardian: _______________
--> Signature ______________________________________________ Date _______________
PHONE: DAD 513-274-8594 MOM 502-544-7887
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Family Membership Agreement
I, the undersigned, being the parent and/or legal guardian of Whitaker Garringer fully understand that the following seven items are conditions of my child be accepted into and participating in the Future Firebirds Basketball Program:
1. I must maintain his/her entire uniform throughout the entire season and realize that if I lose or destroy any part of it, that I must immediately pay $25 per individual item to replace it.
2. I am financially responsible for any bank charges that the Club might incur because of my giving the Club a check that does not immediately clear my account..
3. I realize that regardless of how many games or minutes my son/daughter actually participates in or his/her team plays; there will be absolutely NO refunds of any portion of the player participation fee.
4. While at any Club function (games, practices, meetings, etc.) our entire family unit must always conduct ourselves in a manner consistent with the club's spirit of integrity, decency, and fair play and in conformance with the Metro Behavioral Code of Conduct that each player and parent is required to read and sign..
5. I understand that none of my other children may be in the school building during my child's practices and young children must be supervised at games.
6. I understand and accept that the Club has no tolerance for parental misbehavior. If a player has an adult relative ejected from a game by an official, that adult will no longer be permitted to attend home games. On the 2nd family offense, player will be expelled from the Club – no refunds will be made. Also, if a relative is found "coaching" from the sidelines, they will be asked to leave the game. Please allow the coaches to be the only voice of instruction during the games.
Mother: Courtney Garringer Father: Adam Garringer or Guardian: _______________
--> Signature ______________________________________________ Date _______________
3rd Grade Boys Blue
Kettering Basketball Club Consent Form
PLEASE READ AND SIGN BOTH THE MEDICAL RELEASE AND FAMILY MEMBERSHIP AGREEMENT BELOW
Release Agreement for Minor
I, the undersigned, being the parent and/or legal guardian of Oscar Laravie , a player in the Kettering Basketball Club who is a minor, do hereby understand fully the risks associated with participating in this activity and in consideration of accepting my child for the Kettering Basketball Club and it's programs, do hereby release, discharge and/or otherwise indemnify the Kettering Basketball Club, all it's administrators, coaches, volunteers and associated personnel, against any claim by or on behalf of my child as a result of his/her participation in the Kettering Basketball Club, including being transported to or from Club activities for which I gave verbal or written authorization.
Furthermore, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well being of my dependent named above.
Finally, in my absence I, the undersigned, as the parent and / or legal guardian of my child, do hereby give my consent for the transport of the above named minor, for the purposes of Medical Treatment, and / or Scheduled Practices and / or Games; by his/her coaches.
Mother: Hali Father: Corey or Guardian: _______________
--> Signature ______________________________________________ Date _______________
PHONE: DAD 9379011210 MOM 9379747318
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Family Membership Agreement
I, the undersigned, being the parent and/or legal guardian of Oscar Laravie fully understand that the following seven items are conditions of my child be accepted into and participating in the Future Firebirds Basketball Program:
1. I must maintain his/her entire uniform throughout the entire season and realize that if I lose or destroy any part of it, that I must immediately pay $25 per individual item to replace it.
2. I am financially responsible for any bank charges that the Club might incur because of my giving the Club a check that does not immediately clear my account..
3. I realize that regardless of how many games or minutes my son/daughter actually participates in or his/her team plays; there will be absolutely NO refunds of any portion of the player participation fee.
4. While at any Club function (games, practices, meetings, etc.) our entire family unit must always conduct ourselves in a manner consistent with the club's spirit of integrity, decency, and fair play and in conformance with the Metro Behavioral Code of Conduct that each player and parent is required to read and sign..
5. I understand that none of my other children may be in the school building during my child's practices and young children must be supervised at games.
6. I understand and accept that the Club has no tolerance for parental misbehavior. If a player has an adult relative ejected from a game by an official, that adult will no longer be permitted to attend home games. On the 2nd family offense, player will be expelled from the Club – no refunds will be made. Also, if a relative is found "coaching" from the sidelines, they will be asked to leave the game. Please allow the coaches to be the only voice of instruction during the games.
Mother: Hali Father: Corey or Guardian: _______________
--> Signature ______________________________________________ Date _______________
3rd Grade Boys Blue
Kettering Basketball Club Consent Form
PLEASE READ AND SIGN BOTH THE MEDICAL RELEASE AND FAMILY MEMBERSHIP AGREEMENT BELOW
Release Agreement for Minor
I, the undersigned, being the parent and/or legal guardian of Hudson Mefford , a player in the Kettering Basketball Club who is a minor, do hereby understand fully the risks associated with participating in this activity and in consideration of accepting my child for the Kettering Basketball Club and it's programs, do hereby release, discharge and/or otherwise indemnify the Kettering Basketball Club, all it's administrators, coaches, volunteers and associated personnel, against any claim by or on behalf of my child as a result of his/her participation in the Kettering Basketball Club, including being transported to or from Club activities for which I gave verbal or written authorization.
Furthermore, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well being of my dependent named above.
Finally, in my absence I, the undersigned, as the parent and / or legal guardian of my child, do hereby give my consent for the transport of the above named minor, for the purposes of Medical Treatment, and / or Scheduled Practices and / or Games; by his/her coaches.
Mother: Olivia Mefford Father: Austin Mefford or Guardian: _______________
--> Signature ______________________________________________ Date _______________
PHONE: DAD 9375672196 MOM 9376071726
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Family Membership Agreement
I, the undersigned, being the parent and/or legal guardian of Hudson Mefford fully understand that the following seven items are conditions of my child be accepted into and participating in the Future Firebirds Basketball Program:
1. I must maintain his/her entire uniform throughout the entire season and realize that if I lose or destroy any part of it, that I must immediately pay $25 per individual item to replace it.
2. I am financially responsible for any bank charges that the Club might incur because of my giving the Club a check that does not immediately clear my account..
3. I realize that regardless of how many games or minutes my son/daughter actually participates in or his/her team plays; there will be absolutely NO refunds of any portion of the player participation fee.
4. While at any Club function (games, practices, meetings, etc.) our entire family unit must always conduct ourselves in a manner consistent with the club's spirit of integrity, decency, and fair play and in conformance with the Metro Behavioral Code of Conduct that each player and parent is required to read and sign..
5. I understand that none of my other children may be in the school building during my child's practices and young children must be supervised at games.
6. I understand and accept that the Club has no tolerance for parental misbehavior. If a player has an adult relative ejected from a game by an official, that adult will no longer be permitted to attend home games. On the 2nd family offense, player will be expelled from the Club – no refunds will be made. Also, if a relative is found "coaching" from the sidelines, they will be asked to leave the game. Please allow the coaches to be the only voice of instruction during the games.
Mother: Olivia Mefford Father: Austin Mefford or Guardian: _______________
--> Signature ______________________________________________ Date _______________
3rd Grade Boys Blue
Kettering Basketball Club Consent Form
PLEASE READ AND SIGN BOTH THE MEDICAL RELEASE AND FAMILY MEMBERSHIP AGREEMENT BELOW
Release Agreement for Minor
I, the undersigned, being the parent and/or legal guardian of Ryan Miner Jr , a player in the Kettering Basketball Club who is a minor, do hereby understand fully the risks associated with participating in this activity and in consideration of accepting my child for the Kettering Basketball Club and it's programs, do hereby release, discharge and/or otherwise indemnify the Kettering Basketball Club, all it's administrators, coaches, volunteers and associated personnel, against any claim by or on behalf of my child as a result of his/her participation in the Kettering Basketball Club, including being transported to or from Club activities for which I gave verbal or written authorization.
Furthermore, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well being of my dependent named above.
Finally, in my absence I, the undersigned, as the parent and / or legal guardian of my child, do hereby give my consent for the transport of the above named minor, for the purposes of Medical Treatment, and / or Scheduled Practices and / or Games; by his/her coaches.
Mother: Hannah Father: Ryan or Guardian: _______________
--> Signature ______________________________________________ Date _______________
PHONE: DAD MOM
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Family Membership Agreement
I, the undersigned, being the parent and/or legal guardian of Ryan Miner Jr fully understand that the following seven items are conditions of my child be accepted into and participating in the Future Firebirds Basketball Program:
1. I must maintain his/her entire uniform throughout the entire season and realize that if I lose or destroy any part of it, that I must immediately pay $25 per individual item to replace it.
2. I am financially responsible for any bank charges that the Club might incur because of my giving the Club a check that does not immediately clear my account..
3. I realize that regardless of how many games or minutes my son/daughter actually participates in or his/her team plays; there will be absolutely NO refunds of any portion of the player participation fee.
4. While at any Club function (games, practices, meetings, etc.) our entire family unit must always conduct ourselves in a manner consistent with the club's spirit of integrity, decency, and fair play and in conformance with the Metro Behavioral Code of Conduct that each player and parent is required to read and sign..
5. I understand that none of my other children may be in the school building during my child's practices and young children must be supervised at games.
6. I understand and accept that the Club has no tolerance for parental misbehavior. If a player has an adult relative ejected from a game by an official, that adult will no longer be permitted to attend home games. On the 2nd family offense, player will be expelled from the Club – no refunds will be made. Also, if a relative is found "coaching" from the sidelines, they will be asked to leave the game. Please allow the coaches to be the only voice of instruction during the games.
Mother: Hannah Father: Ryan or Guardian: _______________
--> Signature ______________________________________________ Date _______________
3rd Grade Boys Blue
Kettering Basketball Club Consent Form
PLEASE READ AND SIGN BOTH THE MEDICAL RELEASE AND FAMILY MEMBERSHIP AGREEMENT BELOW
Release Agreement for Minor
I, the undersigned, being the parent and/or legal guardian of Garrett Morter , a player in the Kettering Basketball Club who is a minor, do hereby understand fully the risks associated with participating in this activity and in consideration of accepting my child for the Kettering Basketball Club and it's programs, do hereby release, discharge and/or otherwise indemnify the Kettering Basketball Club, all it's administrators, coaches, volunteers and associated personnel, against any claim by or on behalf of my child as a result of his/her participation in the Kettering Basketball Club, including being transported to or from Club activities for which I gave verbal or written authorization.
Furthermore, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well being of my dependent named above.
Finally, in my absence I, the undersigned, as the parent and / or legal guardian of my child, do hereby give my consent for the transport of the above named minor, for the purposes of Medical Treatment, and / or Scheduled Practices and / or Games; by his/her coaches.
Mother: Casey Morter Father: Josh Morter or Guardian: _______________
--> Signature ______________________________________________ Date _______________
PHONE: DAD 9376847910 MOM 9372415146
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Family Membership Agreement
I, the undersigned, being the parent and/or legal guardian of Garrett Morter fully understand that the following seven items are conditions of my child be accepted into and participating in the Future Firebirds Basketball Program:
1. I must maintain his/her entire uniform throughout the entire season and realize that if I lose or destroy any part of it, that I must immediately pay $25 per individual item to replace it.
2. I am financially responsible for any bank charges that the Club might incur because of my giving the Club a check that does not immediately clear my account..
3. I realize that regardless of how many games or minutes my son/daughter actually participates in or his/her team plays; there will be absolutely NO refunds of any portion of the player participation fee.
4. While at any Club function (games, practices, meetings, etc.) our entire family unit must always conduct ourselves in a manner consistent with the club's spirit of integrity, decency, and fair play and in conformance with the Metro Behavioral Code of Conduct that each player and parent is required to read and sign..
5. I understand that none of my other children may be in the school building during my child's practices and young children must be supervised at games.
6. I understand and accept that the Club has no tolerance for parental misbehavior. If a player has an adult relative ejected from a game by an official, that adult will no longer be permitted to attend home games. On the 2nd family offense, player will be expelled from the Club – no refunds will be made. Also, if a relative is found "coaching" from the sidelines, they will be asked to leave the game. Please allow the coaches to be the only voice of instruction during the games.
Mother: Casey Morter Father: Josh Morter or Guardian: _______________
--> Signature ______________________________________________ Date _______________
3rd Grade Boys Blue
Kettering Basketball Club Consent Form
PLEASE READ AND SIGN BOTH THE MEDICAL RELEASE AND FAMILY MEMBERSHIP AGREEMENT BELOW
Release Agreement for Minor
I, the undersigned, being the parent and/or legal guardian of Alex Neal , a player in the Kettering Basketball Club who is a minor, do hereby understand fully the risks associated with participating in this activity and in consideration of accepting my child for the Kettering Basketball Club and it's programs, do hereby release, discharge and/or otherwise indemnify the Kettering Basketball Club, all it's administrators, coaches, volunteers and associated personnel, against any claim by or on behalf of my child as a result of his/her participation in the Kettering Basketball Club, including being transported to or from Club activities for which I gave verbal or written authorization.
Furthermore, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well being of my dependent named above.
Finally, in my absence I, the undersigned, as the parent and / or legal guardian of my child, do hereby give my consent for the transport of the above named minor, for the purposes of Medical Treatment, and / or Scheduled Practices and / or Games; by his/her coaches.
Mother: Savanna Grieshop Father: or Guardian: _______________
--> Signature ______________________________________________ Date _______________
PHONE: DAD MOM 937-564-3701
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Family Membership Agreement
I, the undersigned, being the parent and/or legal guardian of Alex Neal fully understand that the following seven items are conditions of my child be accepted into and participating in the Future Firebirds Basketball Program:
1. I must maintain his/her entire uniform throughout the entire season and realize that if I lose or destroy any part of it, that I must immediately pay $25 per individual item to replace it.
2. I am financially responsible for any bank charges that the Club might incur because of my giving the Club a check that does not immediately clear my account..
3. I realize that regardless of how many games or minutes my son/daughter actually participates in or his/her team plays; there will be absolutely NO refunds of any portion of the player participation fee.
4. While at any Club function (games, practices, meetings, etc.) our entire family unit must always conduct ourselves in a manner consistent with the club's spirit of integrity, decency, and fair play and in conformance with the Metro Behavioral Code of Conduct that each player and parent is required to read and sign..
5. I understand that none of my other children may be in the school building during my child's practices and young children must be supervised at games.
6. I understand and accept that the Club has no tolerance for parental misbehavior. If a player has an adult relative ejected from a game by an official, that adult will no longer be permitted to attend home games. On the 2nd family offense, player will be expelled from the Club – no refunds will be made. Also, if a relative is found "coaching" from the sidelines, they will be asked to leave the game. Please allow the coaches to be the only voice of instruction during the games.
Mother: Savanna Grieshop Father: or Guardian: _______________
--> Signature ______________________________________________ Date _______________
3rd Grade Boys Blue
Kettering Basketball Club Consent Form
PLEASE READ AND SIGN BOTH THE MEDICAL RELEASE AND FAMILY MEMBERSHIP AGREEMENT BELOW
Release Agreement for Minor
I, the undersigned, being the parent and/or legal guardian of Braxton Stevens , a player in the Kettering Basketball Club who is a minor, do hereby understand fully the risks associated with participating in this activity and in consideration of accepting my child for the Kettering Basketball Club and it's programs, do hereby release, discharge and/or otherwise indemnify the Kettering Basketball Club, all it's administrators, coaches, volunteers and associated personnel, against any claim by or on behalf of my child as a result of his/her participation in the Kettering Basketball Club, including being transported to or from Club activities for which I gave verbal or written authorization.
Furthermore, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well being of my dependent named above.
Finally, in my absence I, the undersigned, as the parent and / or legal guardian of my child, do hereby give my consent for the transport of the above named minor, for the purposes of Medical Treatment, and / or Scheduled Practices and / or Games; by his/her coaches.
Mother: Tiffany Pullen Father: Bria Stevens or Guardian: _______________
--> Signature ______________________________________________ Date _______________
PHONE: DAD MOM 9373718963
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Family Membership Agreement
I, the undersigned, being the parent and/or legal guardian of Braxton Stevens fully understand that the following seven items are conditions of my child be accepted into and participating in the Future Firebirds Basketball Program:
1. I must maintain his/her entire uniform throughout the entire season and realize that if I lose or destroy any part of it, that I must immediately pay $25 per individual item to replace it.
2. I am financially responsible for any bank charges that the Club might incur because of my giving the Club a check that does not immediately clear my account..
3. I realize that regardless of how many games or minutes my son/daughter actually participates in or his/her team plays; there will be absolutely NO refunds of any portion of the player participation fee.
4. While at any Club function (games, practices, meetings, etc.) our entire family unit must always conduct ourselves in a manner consistent with the club's spirit of integrity, decency, and fair play and in conformance with the Metro Behavioral Code of Conduct that each player and parent is required to read and sign..
5. I understand that none of my other children may be in the school building during my child's practices and young children must be supervised at games.
6. I understand and accept that the Club has no tolerance for parental misbehavior. If a player has an adult relative ejected from a game by an official, that adult will no longer be permitted to attend home games. On the 2nd family offense, player will be expelled from the Club – no refunds will be made. Also, if a relative is found "coaching" from the sidelines, they will be asked to leave the game. Please allow the coaches to be the only voice of instruction during the games.
Mother: Tiffany Pullen Father: Bria Stevens or Guardian: _______________
--> Signature ______________________________________________ Date _______________