MARYLAND RAPTORS YOUTH BASKETBALL TRYOUT FORM

Child’s Name

Parent’s/Guardian’s Name

Grade

Home Phone

Work Phone

Address

Zip Code

Street

City

Contact Information

Primary Contact

Secondary Contact

Home Phone

Work Phone

Address

Zip Code

Street

City

Medical Information

Date

I give permission for my child to tryout. I release Maryland Raptors Youth Basketball and individuals associated with the team from liability in case of accident or injury during activities related to Maryland Raptors Youth Basketball.

Parent’s/Guardian’s Printed Name

Parent’s/Guardian’s Signature