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Belton Girls’ Basketball 2013-2014 PIRATE PALS *No cost to participate

SCHOOL: ___________________________ GRADE: K 1 2 3 4 5 6 T-Shirt Size (Cost $5): YS YM AS AM. Belton Girls’ Basketball 2013-2014 PIRATE PALS *No cost to participate *Need to bring form with you at time of sign up

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Belton Girls’ Basketball 2013-2014 PIRATE PALS *No cost to participate

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  1. SCHOOL: ___________________________ GRADE: K 1 2 3 4 5 6 T-Shirt Size (Cost $5): YS YM AS AM • Belton Girls’ Basketball 2013-2014 • PIRATE PALS • *No costto participate • *Need to bring form with you at time of sign up • *Walk ups will be accepted every week. • *Grades: Kindergarten – Grade 6 • PIRATE PALS’ PROGRAM INCLUDES: • Meeting the Girls’ JV/V coaches & players • Pirate Pals individual picture button with JV/V player • Player mentor • Pirate Pal T-shirt-Cost $5 • Introduction of Pirate Pal at a home game • Wear Pirate Pal button for FREE game entry • Home game admission for Pirate Pal ONLY • Picture Date: November 23 • Practice Dates/Times/Location: Saturday’s November 9, November 16, November 23, December 7, and December 14. All times will be 9-10:30 in the Belton High School Gym • PIRATE PALS WILL LEARN BASKETBALL FUNDAMENTALS: DEFENSE-SHOOTING-DRIBBLING-PASSING-REBOUNDING-SCREENING • Questions? • Contact Coach Batchelder • (Belton GBB Head Coach) bbatchelder@bsd124.org • Detach Registration Form & Mail to Coach Batchelder • 107 W. Pirate Parkway, Belton, MO 64012 • Or bring in as a walk up • Checks may be made out to: Belton Girls’ Basketball Last Name: _________________ First Name: ______________ Parent/Guardian Name: _________________________________ Mailing Address: _____________________________________________________ _____________________________________________________ Email Address: ________________________________________ Phone Number: _______________________________________ I understand that neither the Belton schools nor Brad Batchelder and his coaching staff provide neither medical insurance nor will either be held responsible for medical expenses. I hereby authorize Brad Batchelder and his coaching staff to act for me according to their best judgment in any emergency situation requiring medical attention and hereby waive and release Brad Batchelder and his coaching staff from any and all liability for any injuries. I also certify that my child is medically and physically fit to participate in the Pirate Pals program. _____________________________________________________________ Parent / Guardian Signature Date

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