Registration Information
 Player's Name:
City, State, and Zip:
Parent / Guardian:
Birthday (mm/dd/yy):
Grade / Age:
***Please note you will need to submit the registration by clicking the submit button above and then turn in your fee check.
I do hereby acknowledge, recognize and accept the inherent risk of bodily injury, disability, paralysis and/or death to myself/ourselves and/or my/our children that exists as a result of my/our participation in any athletic endeavor, and specifically, by my/our participation in athletic endeavors offered or hosted by the INDIANA BLIZZARD or it's partners. As such, I/we do hereby agree to save, hold harmless and indemnify the Indiana Blizzard, its owners, employees, agents, and other individuals or entities operating on behalf of the INDIANA BLIZZARD, for any bodily injury, disability, paralysis, and/or death, that I/we and/or my/our child(ren) may sustain as a result of my/our participation in any athletic endeavor offered.

In the event that I or my/our child(ren) suffer some type of injury or illness which requires immediate medical treatment, I do hereby consent to and authorize the administration of such first aid and/or medical treatment to myself/ourselves and or my/our child(ren) by employees and/or agents of the INDIANA BLIZZARD. I/we do further consent to and authorize employees and/or agents of the INDIANA BLIZZARD to arrange for ambulance transportation for an appropriate medical facility for me/us and/or child(ren). I understand that once players are registered and fees paid, they are non-refundable.
Parent or Guardian Initials for Consent
Filling out the above registration form and payment of the  membership fee is mandatory for any players to play for Indiana Blizzard teams. No player will be considered officially registered and on the roster or eligible for any events until fees are paid and registration is complete.
T-shirt Size:
Coach's Name:
Under Armour Grassroots Basketball Club
Additional Comments:
I have read and agree to all terms and conditions above.