Thesa Rider Application and Release - Sport ___________________

Name of Player ___________________________________________________

Address _________________________________________________________

City, ZIP ________________________________________________________

Home Phone __________________Dad’s Work__________________Mom’s Work_______________

Birthdate ______________________ Grade_________ Age today _________

Parents' Names:_____________________________________________________

Dad’s Cell: __________________ Mom’s Cell: ___________________ Player’s Cell: ______________

Parents’ email________________________  Player’s email or secondary email______________________

Attending any organized school classes? If yes, what school and how many courses? _____________________________________________________________________

How many years have you been educated at home? _______ 

Any physical limitations? ______  If yes, please describe on back of sheet.

How many years of high school basketball? ________

How many years have you played this sport?____________At what level?__________________________

What team did you play on last year? _______________ What positions do you like to play? _________________

Uniform Size: T-Shirt________ Jersey _________ Basketball Shorts_________ Shoes ______

Statement:  I would rather sit the bench on varsity than play full time on junior varsity:  Yes  or  No

Player’s Declaration of Behavior and Attitude – To be signed below.

"As a Riders participant, I will promote Christ-like sportsmanship through playing fairly, respecting authority, and being a positive loser and a gracious winner. I will also promote Christ-like character through faithful attendance and participation in all sporting events and fundraisers. My attitude and appearance will reflect Christ at all times."

Player’s signature:________________________________ Date: ________________

Parent’s Declaration of Behavior and Attitude – To be signed below.

"As the parent of a Riders participant, I will model and promote Christ-like sportsmanship through giving positive encouragement, respecting authority, and being a positive loser and a gracious winner."

Parent’s signature: _________________________________ Date: ________________

Release for Player’s Under Age 18.

Permission and Release: I hereby declare that my child is physically able to participate in strenuous activity such as competitive athletics and this tryout.  Accordingly, I give permission for my child to participate in this activity. In the event he/she is injured, I waive and release all rights to any claim for damages against the sponsor or its representatives, including Texas Home Educators’ Sports Association, coaches and directors. I further agree that any claim or dispute arising from or related to this agreement shall be settled by mediation and, if necessary, legally binding arbitration, in accordance with the Rules of the Institute for Christian Conciliation; judgment upon an arbitration award may be entered in any court otherwise having jurisdiction.

Medical Treatment: In the event my child suffers sudden illness, accident, or injury and neither parents nor guardians can be contacted, I give permission for any emergency treatment that is deemed necessary by a licensed physician.

Family physician ____________________________________________Phone ____________________

Pertinent medical information (diabetes, allergies, asthma, etc.):

By signing this form you are agreeing to all statements above regarding release of liability and medical treatment.

Parent’s signature: _______________________________ Date:_________________