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Blacktop Basketball Tournament

This event has ended

Date: September 15, 2018
Location: South Whitley Town Park Basketball Courts
Rain Venue: Whitko Jr/Sr High School
Cost: $20.00 per team

Divisions:

4th & 5th Grade

6th – 8th Grade

Open Division

Registration 8:30-915 am

Mail registration to P.O. Box on form or fill out below.

Mail payment to P.O. Box of pay on site with cash

Sponsored By:

South Whitley Parks and Recreation
&
Whitko Boys Basketball

Registration
  1. *Each Member must complete a registration form, only one waiver is needed per team with all participants parent/guardian signatures

  1. MaleFemale
Contact Information
In Case of Emergency Contact
Confirmation
  1. $ Team Cost: $20.00

    Cash/Checks made payable to: South Whitley Parks and Recreation

    *Money and registration can be mailed to PO Box 476, South Whitley, IN 46787

    I, the undersigned parent/guardian, do hereby grant permission for my son/daughter, named above, to participate in the fall festival blacktop
    basketball tournament. In order that my child may receive the proper medical treatment in the event that he/she may sustain injury or illness
    during the Blacktop Basketball Tournament, I hereby authorize the league staff to obtain or provide medical treatment for my child for such
    injury or illness during the tournament, and I hereby hold the South Whitley Parks and Recreation or Whitko Boys Basketball staff and
    sponsoring organization, as well as its representatives, harmless in the exercise of this authority.

    I further understand that there is always a possibility that my child may sustain physical illness or injury while at the league. If this occurs, I
    hereby authorize the tournament staff and representatives to refer my child to a medical treatment center (hospital, etc.). I further acknowledge
    and understand that I will be responsible for any medical bills that may be incurred on behalf of my son/daughter for physical illness or injury
    that he/she may sustain during the tournament.

    Understanding there is always a possibility that my child may sustain physical illness or injury, I acknowledge and understand that my child is
    assuming the risk of such physical illness or injury by his/her participation, and I further release the sponsoring organization and its
    representatives from any claims for personal illness or injury that my child may sustain during the tournament. I further acknowledge and
    understand that my child will be responsible for his/her failure to abide by the rules and regulations of the tournament.