YOUTH BASKETBALL REGISTRATION FORM 2017/18

PUTNAM YOUTH BASKETBALL REGISTRATION

(For Putnam Residents Only)

Available on our website @ www.putnamct.us  

YOU ARE WELCOME TO

MAIL OR BRING TO:

PUTNAM RECREATION DEPT.

**NEW** SECOND FLOOR

126 CHURCH ST.

PUTNAM, CT 06260

FINAL REGISTRATION DATE: WEDNESDAY DEC. 6, 2017

TIME: 4:30 – 6:00 PM Putnam Middle School Cafeteria

__________________________________________________________________________________

MAY BE RETURNED TO PES OPEN HOUSE

THURSDAY NOV.16TH 1:30-3:15PM & 5:30-7:30 PM

AND FRIDAY NOV. 17TH 1:15-3:30PM

Children ages 5-14 (No High School Students)

FIRST DAY FOR ALL DIVISIONS - SATURDAY – DECEMBER 9, 2017

AT PUTNAM MIDDLE SCHOOL GYM

*Primary Division (Ages 5-7) 8:30-9:30 (Sat. mornings only)

Girls Junior - (Ages 8-10) 9:30-10:30 am Saturday (Wed. night practice)

Girls WNBA Ages (11-14) 9:30-10:30/Saturday (Wed. night practice)

Boys Junior (Ages 8-9) 10:30-11:30/Saturday (Wed. night practice)

Boys Senior (Ages 10-11) 11:30-12:30/Saturday (Thurs. night practice)

Boys NBA (Ages 12-14) 12:30-1:30/Saturday (Thurs. night practice)

Fee: $20.00 for season (includes end of year tourney)

($40.00 family maximum)

(NO SUNDAY GAMES)

 

REGISTRATION FORM

PUTNAM YOUTH BASKETBALL

 

NAME ______________________________________________________AGE_____________

            Last                                       First                             MI

 

ADDRESS_____________________________________________________________________________________________________________________________________

TELEPHONE_________________________________________DIVISION__________

Please circle size – Youth T-shirt – (S) (M) (L) (XL)

 

I, the undersigned, release the Town of Putnam and its employees from any and all damages I may have against them for all injuries suffered by the individual registered above in said Youth Basketball. I have been given information concerning concussions and will monitor any occurrences.

Please advise us of any medical conditions or needs: (i.e., asthma – diabetic conditions – stamina conditions)

__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

                                                                        ____________________________________

                                                                        Signature of Parent or Guardian

 

CHECKS PAYABLE TO: PUTNAM YOUTH BASKETBALL

 

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