Spring Season - April 9 - June 8, 2012
Games Location - Lakelands Park Middle School
Practice - Onces a week, Weekday evenings
Game - once a week Weekday and Saturday or Sunday evenings
Draft - Lakelands Park MS
Division III [Age 9 - 11] DOB after June 1, 2000 - Friday 3/23 6:00 PM
Division II [Age 12 - 13] DOB after June 1, 1998 - Friday 3/23 7:30 PM
Division I [Age 14 - 15] DOB after June 1, 1996 - Wednesday 3/28 8:00 PM
All participants are guaranteed a team roster spot.
APPLICATION
Applicant Name: __________________________________________ Date of Birth: ___________
Address: _______________________________________________________________________
Parent's Email: ___________________________________ Telephone: _____________________
Emergency Contact Name & Telephone #: ______________________________________________
Height: ______ Weight: _______ School: _________________________ Grade: _____ [Fall 2011]
I hereby grant permission for my child to attend the basketball program supported by Jr. NBA and its member MIBG. I understand that I am responsible for my child's insurance in case of injury. Furthermore, I understand that although safety precautions will be observed, Jr. NBA, MIBG, their employees and agents will not be responsible for any personal lost by my child or for any injury sustained in the program. I also consent to Jr. NBA and MIBG for the use of any photographs, CDs and video made of the program.
Please make $ 200 check payable to MIBG
Mail to - 267 Kentlands Blvd. P.O.Box 1062 Gaithersburg, MD 20878
Parents/Guardian Signature: _________________________________ Date: _______________