Oak Harbor Energy 3v3 Basketball

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Participation in Energy 3v3 Basketball spring league is $50. Upon submission, you will be redirected to the payment area.

See you in the gym!

Email *

Athlete's Last Name *

Athlete's First Name *

Current Grade in School *

Jersey Size *

Youth Small

Youth Med

Youth Large

Other:

Does your student have any allergies or any other medical conditions of concern? *

Medical Insurance Company *

Insurance Group Name/Number *

Insurance Policy Number: *

Student's Primary Physician/Pediatrician: *

Primary Physician/Pediatrician's Office Number: *

Name Parent/Guardian *

Email *

Phone *

Emergency Contact Name #1: *

Emergency Contact Phone #: *

Emergency Contact Name #2: *

Emergency Contact #2 Phone: *

OHHS 3v3 Basketball League Waiver Agreement

I represent that my child is physically able to participate in the program. I fully understand that his/her participation may entail the risk of physical injury, and am aware that all sports and activity have some inherent risks and injury can occur. I agree to waive any claim, whether resulting from an injury or otherwise, and further agree to release, indemnify, and hold harmless this program, the school district, high school, and the coaches and staff operating the League.
In consideration of my child being allowed to participate, I, the parent/guardian, assume the risk of all injury and release Oak Harbor Public Schools, Oak Harbor High School, and this program, and its directors, employees, and volunteers from liability in the case of all injuries caused by or resulting from participating in the 3v3 Basketball League.

If you, as Parent/Guardian, agree to the above 3x3 Basketball League, click "I Agree" on the following question.

I Agree

I disagree

Medical Consent

OHHS 3v3 Basketball League will make every effort to contact me in the case of an emergency. I give my permission for 3v3 Basketball League and its directors to provide and arrange for any necessary medical treatment to my children while at the 3v3 Basketball League, including onsite and offsite emergency care. I accept responsibility for the costs of all such medical treatment.

Medical Consent Agreement
*

I Accept

I Decline medical care for my child

Required

Photography Release:

In consideration of my child's participation in the 3v3 Basketball League, I hereby grant permission to 3v3 Basketball League and the OHPS to utilize photographs featuring my child in media for the purpose of promotion of OHPS and the 3v3 Basketball League .

Photography Release Agreement:
*

I Accept

I Decline photography release for my child

Required

Concussion Form and Sudden Cardiac Arrest Form

Cardiac Arrest

Concussion Form

Please read through the two informational files on Concussions and Sudden Cardiac Arrest. After reviewing this information, please confirm below:
*

Column 1

I have read and reviewed the Concussion Form

I have read and reviewed the Sudden Cardiac Arrest Form

By typing your name below, you are electronically signing this form. This signature confirms the previous information is correct, and you are giving permission to your child to participate in the 3v3 Basketball League.
*

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Oak Harbor School District. Report Abuse

Forms