Registration "*" indicates required fields Player InformationPlayer's Name* First Last Age*Birth Date* MM DD YYYY Grade*Select a Grade2nd Grade3rd Grade4th Grade5th Grade6th GradeHeight*Shirt Size*Youth SmallYouth MediumYouth LargeYouth XLAdult SmallAdult MediumAdult LargeAdult XLYears of Basketball Experience*Did you play OMGBL last year?* Yes No Address* Street Address Address Line 2 City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code List any physical or medical limitations of which the coach needs to be aware:Allergic to any medications:Doctor's Name*Doctor's Phone*Hospital Preference*Parent InformationParent's Name* First Last Home Phone*Work Phone*Cell Phone*Email* Parent's Name First Last Home PhoneWork PhoneCell PhoneEmail Emergency Contact (other than parent)* First Last RelationshipHomeWorkCellI would like to: Head Coach Assistant Coach Do you have coaching experience? Yes No Describe your coaching experience.Player Registration Price: Product NameThe undersigned parent or guardian understands that their daughter will be engaging in physical activity during league practice and games and that there are inherent risks of physical injury and the undersigned assumes the risk and releases the OMGBL, OM High School, OM Middle School, Shelby County Board of Education, its officers, director agents and employees from any and all liability for personal injury arising out of your child’s participation in the league. I hereby authorize officials, coaches, assistants, team parent or any responsible persons delegated to any of the above to take my child to the nearest hospital or any accredited medical establishment for emergency treatment in case of injury during practice and/or games if the parents are not available. She is physically fit according to our family physician, and I further agree to pay through my insurance company or otherwise for any medical treatment that may be necessary. Total Credit Card*
