TEAM SYNERGY REGISTRATION 2025 SPRING

Date of Birth *

Gender *

Male

Female

Skill Level *

Beginner

Experienced

Advanced

School Name and City *

Age *

Grade *

Players Full Name *

TEAM UNIFORM SIZE *

1.) Parent / Guardian's Full Name *

Email *

Phone number *

Home Address *

City *

2.) Parent / Guardian's Full Name

Email

Phone number

Permission and Liability Waiver

As the parent or legal guardian of the above-named player, 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 your child. I agree to hold Synergy Basketball, LLC harmless for any injury that may result from activities in the Synergy Basketball Program. I, the parent/ guardian assumes all risks and hazards incidental to the conduct of the Synergy Basketball Program activities. I also give my permission for the Synergy Basketball Program to publish, copyright, or use all films and photographs in which my son/ daughter is included for any exhibitions, displays, web pages and publications without reservation or compensation. *