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  Ashton Adams , 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:  Adrienne   Father:  Matt         or  Guardian:    _______________

                                                                                                                                                                        

 

-->     Signature      ______________________________________________   Date   _______________

 

PHONE: DAD 9372312696  MOM 9372381417

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Family Membership Agreement

I, the undersigned, being the parent and/or legal guardian of   Ashton Adams 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:  Adrienne   Father:  Matt         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  Daniel Braun , 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:  Holly   Father:  Todd         or  Guardian:    _______________

                                                                                                                                                                        

 

-->     Signature      ______________________________________________   Date   _______________

 

PHONE: DAD 937-479-0981  MOM 937-361-2902

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Family Membership Agreement

I, the undersigned, being the parent and/or legal guardian of   Daniel Braun 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:  Holly   Father:  Todd         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  Ned Bruzzese , 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:  Emily Bruzzese   Father:  Tony Bruzzese         or  Guardian:    _______________

                                                                                                                                                                        

 

-->     Signature      ______________________________________________   Date   _______________

 

PHONE: DAD 937-474-2967  MOM 937-474-2964

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Family Membership Agreement

I, the undersigned, being the parent and/or legal guardian of   Ned Bruzzese 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:  Emily Bruzzese   Father:  Tony Bruzzese         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  Carson Dewald , 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:  Kelly Dewald   Father:  Mark Dewald         or  Guardian:    _______________

                                                                                                                                                                        

 

-->     Signature      ______________________________________________   Date   _______________

 

PHONE: DAD 937-620-6934  MOM 937-620-9502

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Family Membership Agreement

I, the undersigned, being the parent and/or legal guardian of   Carson Dewald 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:  Kelly Dewald   Father:  Mark Dewald         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  Eli Edwards , 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:  Jenny   Father:  Matt         or  Guardian:    _______________

                                                                                                                                                                        

 

-->     Signature      ______________________________________________   Date   _______________

 

PHONE: DAD   MOM 9373214975

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Family Membership Agreement

I, the undersigned, being the parent and/or legal guardian of   Eli Edwards 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:  Jenny   Father:  Matt         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  Josiah  Hargrave , 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:  Letitia    Father:  Jerod         or  Guardian:    _______________

                                                                                                                                                                        

 

-->     Signature      ______________________________________________   Date   _______________

 

PHONE: DAD 267-971-7919  MOM 267-971-6577

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Family Membership Agreement

I, the undersigned, being the parent and/or legal guardian of   Josiah  Hargrave 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:  Letitia    Father:  Jerod         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  Liam Harkenrider , 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:  Kathryn    Father:  Andrew         or  Guardian:    _______________

                                                                                                                                                                        

 

-->     Signature      ______________________________________________   Date   _______________

 

PHONE: DAD 937-414-5857  MOM 937-510-3319

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Family Membership Agreement

I, the undersigned, being the parent and/or legal guardian of   Liam Harkenrider 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:  Kathryn    Father:  Andrew         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  Nico Mastro , 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:  Nicole Mastro   Father:          or  Guardian:    _______________

                                                                                                                                                                        

 

-->     Signature      ______________________________________________   Date   _______________

 

PHONE: DAD   MOM 9374795985

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Family Membership Agreement

I, the undersigned, being the parent and/or legal guardian of   Nico Mastro 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:  Nicole Mastro   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  Vincent  Seaton , 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:  Lyndsay Seaton   Father:  Dan Seaton         or  Guardian:    _______________

                                                                                                                                                                        

 

-->     Signature      ______________________________________________   Date   _______________

 

PHONE: DAD 9374787790  MOM 9374788112

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Family Membership Agreement

I, the undersigned, being the parent and/or legal guardian of   Vincent  Seaton 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:  Lyndsay Seaton   Father:  Dan Seaton         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  Jaion Walker , 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:  Jaclyn Stinson   Father:          or  Guardian:    _______________

                                                                                                                                                                        

 

-->     Signature      ______________________________________________   Date   _______________

 

PHONE: DAD   MOM

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------  

 

Family Membership Agreement

I, the undersigned, being the parent and/or legal guardian of   Jaion Walker 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:  Jaclyn Stinson   Father:          or  Guardian:    _______________

                                                                                                                                                                        

 

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