ANSON REC. BASKETBALL SIGN UP
3RD – 5TH GRADE
The Anson Rec. Basketball program will have teams for 3rd – 5th. We will need parent volunteers to help make our Basketball program run smoothly.
Please return your permission slips to your school or the Anson Town Office no later than November 2nd, 2017
If you have any questions please contact Tammy Murray at 696-3979.
I WILL BE ABLE TO COACH – (circle one) YES OR NO
This program is not affiliated with MSAD# 74 or RSU #59, which means no participants have access to inside the school and transportation is NOT provided. Children will be unsupervised if they arrive before practices or games begin and if they aren’t picked up promptly after practices or games.
We recommend that your child ………………..
- Uses the restroom @ home before arriving
- Bring their own water
- Dress appropriate: t-shirt, shorts or sweats, sneakers
- PLEASE know that although we want the children to have fun, we also NEED them to be on their best behavior and listen carefully to the coaches while they are on the field. Fighting, pushing, inappropriate language, tripping and other unacceptable behavior will not be tolerated.
BASKETBALL PERMISSION FORM
I give _________________________________ permission to play basketball with Anson Rec. and do not hold the Town of Anson, MSAD #74 & 59 or any volunteers responsible for any injuries that may occur. I assume all risks of any injury___________________________ may receive as a result of playing
Basketball. UNIFORM SIZE YOUTH: S, M, L, XL or Adult S, M, L, XL
Parent/Guardian Signature Date
Parent/Guardian name PRINTED PHONE # Childs Name Grade
Emergency Contact Info (Name and Phone #)
Any medical conditions that you feel the coaches should know about? (Asthma, bee allergies, etc.)
Are you interested in being a volunteer?
____ ____ ______________________________________
Yes NO Name and Phone #