Child's Name (required)

Child's Grade (required)

Child's Gender (required) Child's Birthdate (required)

Address (required)

State (required)

City (required)

Country (required)

Parents Name (required)

Phone Number: (required)

Your Email (required)

Emergency Contact

Phone Number: (required)

Doctor Name

Phone Number: (required)

Has your child played League Basketball before?

What League or Team?

CONSENT FOR MEDICAL TREATMENT

As the parent or legal guardian of the above named registrant, I hereby give 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 life, limb or well-being of my dependent.

Insurance Carrier

Phone Number: (required)

WAIVER OF LIABILITY

I, the parent/guardian of the registrant, a minor, agree that the registrant and I will abide by the rules of the South Fulton Lions Basketball Club., its affiliated organizations and sponsors. Recognizing the possibility of physical injury associated with youth sports programs and activities, I hereby release, discharge and/or otherwise indemnify the South Fulton Lions Basketball Club., its affiliated organizations and sponsors, their employees and associated personnel including the owners of facilities utilized for the programs, against any claim by or on behalf of the registrant as a result of the registrants participation in the programs and/or being transported to or from the same with transportation I hereby authorize.
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