Name ______________________________________________________________________

Address ______________________________________________________________________

City _______________________________ State __________ Zip ______________

Phone ______________________________________________________________________

E-Mail ______________________________________________________________________

Grade (fall 2008) ___________

School Name______________________________________

Height________________         Weight_________________

T-Shirt Size (adult):   S   M   L   XL   XXL

Medical condition(s) we should be aware of:
______________________________________________                                     (attach aditional sheet, if necessary)

Parental Waiver Agreement

In consideration of acceptance of this application for enrollement in the Aspen Basketball Academy, I waive and release any and all rights and claims for damages I may have against the Aspen Basketball Academy, all sponsors and all employees and agents of the Aspen Basketball Academy. I herby grant permission for my child to be a participant in the Aspen Basketball Academy and if an injury should occur during, traveling to or returning from the Academy, I agree to pay all costs, present and future, through my medical insurance policy and/or personal finances.

_____________________________________________________________
Parent/Guardian Signature & Date

Please copy and submit form to abahoopitup@yahoo.com

and then go to https://shop.aspenbasketballacademy.com and register for the appropriate camp. Be sure to include players name and parents name on the online registration.

Alternatively,

Mail this completed form and check to:

ASPEN BASKETBALL ACADEMY
ATTN: Steve Ketchum
905 Lupine Circle
Basalt, CO 81621

(Make checks payable to “Aspen Basketball Academy”)