Aid for AMF Basketball Registration Form

AMF Basketball Program Registration

Player Information:

Player's First name

Player's Last name

Player's Birthday

Player's Age

Player's Address

Parent/Guardian Information:

Parent 1 Full Name

Parent 1 Phone

Parent 2 Full Name (optional)

Parent 2 Phone (optional)

Emergency Contact Information:

Emergency contacts must be:

18 years or older
different from parent/guardian already listed
a licensed driver

Emergency Contact Full Name

Emergency Contact's Phone

Photo Release Consent:

Aktive Minds Foundation may take photos throughout the course of the program. These photos will be used for websites, social media pages, and other marketing materials such as flyers, newsletters, etc. Do you give AMF consent to use photos containing your child?

Yes, I give consent.

No, I do NOT give consent.

Liability Release Waiver:

I have read, understand, and agree to the liability release waiver terms and conditionsView terms and conditions

The signature below indicates and authorizes voluntary consent of a parent/guardian "Releasor" defined in the Liability Release Waiver above.

The program payment for your participant has been waived. Please check the box below to indicate that you are a recipient of financial assistance.

Aktive Minds Foundation is happy to help eliminate barriers for youth participation and increase community engagement!

Payment Type

Financial Assistance

Thanks for registering! Be sure to check your email for season information!