First Name *

Last Name *

Gender *

Male

Female

Birthdate *

Age *

Grade *

Height *

School *

Are you a returning player? *

Yes

Which team?

T-shirt Size *

Email Address *

Address *

City *

Postal Code *

Parent/Guardian Name *

Home Phone

Work Phone

Cell Phone

Emergency Contact Name *

Emergency Phone

Please check below if you are interested in helping with one of the following

Coach

Assistant Coach

Volunteer

For which team?

Participant Consent *I give permission for my child, whose name appears above, to participate in the Orion Basketball program. I understand the nature of sports activities and the minor’s experience and capabilities and believer the minor to be qualified, in good health, and in proper physical condition to participate in such activity.
I do hereby authorise Orion Basketball as agents for the under-signed to consent to X-ray examination, anesthetic, medical, or surgical diagnosis or treatment and hospital care which is deemed advisable by, and is to be rendered under the general or specialized supervision of any physician licensed under the provisions of the Medial Practice Act of the staff of a licensed hospital, whether such diagnosis or treatment is rendered at the office of said physician or a said hospital. It is understood that this authorization is given in advance of such diagnosis, treatment, or hospital care, which the aforementioned physician in the exercise of his best judgement may deem advisable. This authorization shall remain effective for the duration of the program, unless revoked sooner in writing and delivered to say agent.

I agree

Refund Policy *The house league, super league and summer camp registration is non-refundable and non-transferable. If you choose to cancel your registration, the fee is refundable up to two weeks before the program starts minus the online registration fee and a $25 processing fee. Sessions will not be rescheduled if they are altered or cancelled due to school functions, LDCSB and COVID-19 restrictions and protocols. If remaining sessions beyond the half way point are cancelled from school closures due to the current or new pandemic, remaining session money will not be refunded or transferred. If we do not complete half the sessions, remaining session money will be refunded. In the case that a child needs to cancel prior to attending a program due to a medical reason, a full refund will he given upon receipt of a medical note. If a child comes late or leaves early for reasons other than medical necessity there will be no refund.

I agree

Consent to Use Images on Social Media *I hereby grant Orion Basketball and its representatives the right to use, publish, and display photographs, video recordings, and audio clips of the participant taken during the basketball season on the official website, social media channels (Instagram, Facebook, YouTube, TikTok), and promotional and marketing materials (print or digital). I understand that no financial compensation or royalty will be provided for the use of these images or videos. I release Orion Basketball, its coaches, and organizers from any claims or liability arising from the use or publication of these media materials. This consent remains valid for the duration of the current season unless revoked in writing.

I agree

Weeks	Price

House League Grades 2-4 Boys and Girls – WEDNESDAY Program