CONTACT NAME     

If you are registering a team:
Team name:

Age group: 8 - 10 11 - 13 14 - 16 17+

Sex: male     female

Name of player one, two and  three and optional substitutes:

Phone:
Second Phone:

 Parent/guardian name(s):

If you are registering an individual player:
Your  name:

 Age group: 8 - 10 11 - 13 14 - 16 17+

Sex: male     female

Phone:
Second Phone:

Players under 18 MUST bring a guardian to sign the waiver.

By checking the box below you agree to the following: I hereby request that my child be admitted to the Jeff Smith 3on3 tournament. I hereby authorize and direct the staff to exercise and act in their best judgment in the event any medical emergency regarding my child may arise. I also hereby confirm that my child is covered by accident insurance which provides coverage for any accidental bodily injury. By checking the box below,  I hereby agree to hold harmless   to the Jeff Smith 3 on 3. and any of its agents and/or employees in connection with any incident or occurrence arising out of my child’s enrollment in the tournament

I accept: