FABA - DC METRO // Filipino American Basketball Association

Note: For those who are not comfortable to use the on-line registration due to security reasons, please download the form here and mail it to us along with your check by November 11, 2007 ."

FABA of METROPOLITAN DC - PERMISSION AND RELEASE FORM

Activity (FABA DC-Metro, Inc Sport)

Name:

Birthdate:

Height: (ft.)

Weight: (lbs.)

Home phone:

Address:

Email Address:

School Name:

Parent's / Guardian's Name:

Health Insurance:

Emergency Contact No.

*** All information collected is confidential.

I/We hereby permit Our Child/Myself to participate in the Basketball Activity of the Filipino American Basketball Association (FABA DC-Metro, Inc). I/We recognize that the activity requires the time, energy and supervision of volunteers and the cooperation of FABA DC-Metro, Inc. to be a success.

Therefore, I/We accept responsibility for all injury to the person and property of Our Child/Myself while he/she is participating in the activity. Further I/We release, hold harmless and will indemnify the FABA DC-Metro, Inc., its officers, directors and agents, the umpires/referees, including its coaches, and moderators from all responsibility for personal injury to or caused by Our Child or myself/ourselves and loss of or damage to the personal items of Our Child/Myself which may occur during travel time, practices, participation in the activity, and at any other time involved in the activity. I/We have sufficient medical and/or accident insurance for Our Child/Myself.

By this permission Form, I/We hereby expressly authorize the coach or the coach’s designee the right to permit emergency medical treatment in the event that it ever becomes necessary and I/We accept the personal responsibility for the cost of such treatment. I/We certify that Our Child/Myself is in good health, free from physical disability, which would make the participation in this activity inadvisable. I/We will advise the coach or representative of any information that I/we may acquire in the future which would render Our Child/Myself incapable for health or other reasons of full participation in this activity. This permission, release, holds harmless and indemnification is given to endue FABA DC-Metro, Inc. to allow Our Child/Myself to become a member of and participate in the activity.

FABA DC-METRO, INC. CODE OF CONDUCT

At no time may a spectator:


	· Approach an official, timekeeper or scorekeeper in a confrontational manner.

	· Enter the playing court area. Spectators are to remain in the bleachers.

	· Engage in un-sportsmanlike conduct, including negative cheering, yelling or distraction during free throws, towards an opposing team’s spectators, players or coaches.

	· Smoke, eat or drink in any gym.

	· Congregate in the playing area, near team benches, or in foyer areas of the gym after a game has completed.

I/We have read the above code of conduct and I/We agree to abide by its terms. I/We are aware that failure to abide by the above terms may result in disciplinary action by FABA DC-Metro, Inc., which may include, but not be limited to, forfeiture of game(s) and/or revokement of my/our privileges to attend FABA DC-Metro, Inc. games.

T-shirt size:

XX-LARGE	LARGE	SMALL
X-LARGE	MEDIUM
Note: Must add an extra $2 for any sizes larger than XX Large.

Division:

Registration Fee: ------------------------------------- $650.00
Deadline Date: ----------------------------------------- 11/11/2007.

Application form and fees needs to be submitted on or before the due date otherwise FABA will assess a $10.00 fees for any late application. No forms will be accepted after the 11th of November 2007.
Thank you.

Please make the check payable to: FABA of Metro DC

Send the form along with the check to the address below:
FABA of Metro DC c/o Ken Mendoza
9671 Franklin Woods Place
Lorton, VA 22079

I hearby accept and agree to all rules, guidelines, and requirements of FABA.