Mission Valley Basketball League

2009-20010

Team Name:                                                                             Contact Person: __________________________________                                  Address:                                                               Ph#:                                Fax ________________City_____________

Division Entered and Team Name listed below         (Grade in during 2008-2009 school year)

3rd – 4^th Grade Division____________________________5^{th -} 6^th Grade Division___________________________                                                                                                

Signups require a $100.00 sponsor fee with logo plus $20.00 per player (a minimum of 8 players per team) the following waiver must be signed for each team. Game dates are Dec. 5^th, 12^th, 19^th, Jan. 9^th, 16^th,  23^rd, at Polson Linderman Gym. 

My team would like to participate in the Mission Valley Basketball League. I have enclosed a roster (below) and the sponsor fee of $100.00 plus $20.00 per player (minimum of 8 players per team.* By signing my name on the roster below, it is understood that the undersigned will comply with the rules of the Mission Valley Basketball League. This form releases all area high schools and all of those associated with this event from any liability, which may occur while participating in this event.  I understand by the nature of the activity there is the possibility of accident and assume the risk and responsibility while attending the Mission Valley Basketball League.  I, as a Parent/Guardian of a minor student, permit emergency care to be administered to him as deemed necessary by the Mission Valley Staff.  I will allow the involved hospital and or doctor to administer the required treatment of the emergency condition.  I also understand that all incurred costs are my personal responsibility and that Mission Valley Basketball League does not have insurance coverage for injuries to League participants.

Please return by Tuesday, November 24^th, 2009. No Refunds after this date.

                                                           Please write in shirt size below (YM, YL, AS, AM, AL, AXL, AXXL)

   Player Name-please print                          Parent Signatures                                        Shirt Size

1.___________________________                                                                                                             

2___________________________                                                                                                              

3___________________________                                                                                                              

4. ___________________________                                                                                            

5. ___________________________                                                                                            

6___________________________                                                                                                              

7___________________________                                                                                                              

8. ___________________________                                                                                            

9. ___________________________                                                                                            

10. ___________________________                                                                                          

Coaches shirt sizes ____________________                              Sponsors shirt size_____________________ 

*Please make all checks payable to Mission Valley Basketball League:   Deliver check along with completed form to:  

Steven Woll 

676-3390 xt 3446 school  - 261-1521-cell  

Scott Wilson

883-6350 xt 229 school  -249-8674-cell