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Recreation Center Sign-Ups
First Name
(Required)
Last Name
(Required)
Which Sport?
Basketball
To be paired with a sibling, the children must reside in the same household. Pair with sibling
(Required)
Paired
Yes
No
Sibling's Name to be paired with
First
Last
Address
(Required)
Street Address
City
State / Province / Region
ZIP / Postal Code
Phone
(Required)
Email
(Required)
Age
(Required)
Please enter a number from
2
to
99
.
Gender
(Required)
Male
Female
Sport
(Required)
Date of Birth
(Required)
MM
1
2
3
4
5
6
7
8
9
10
11
12
DD
1
2
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31
YYYY
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
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1991
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1989
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1981
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1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Height
(Required)
Weight
(Required)
Shirt Size
(Required)
Youth XS
Youth S
Youth M
Youth L
Youth XL
Youth 2XL
Youth 3XL
Adult Extra Small
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2XL
Adult 3XL
Adult 4XL
Pants Size
(Required)
Youth XS
Youth S
Youth M
Youth L
Youth XL
Youth 2XL
Youth 3XL
Adult Extra Small
Adult Small
Adult Medium
Adult Large
Adult XL
Adult XXL
Adult 3XL
Adult 4XL
Last Year's Team
Jersey Number (choose up to three options)
(Required)
Guardian's Name
(Required)
First
Last
Guardian's Phone
(Required)
Additional Guardian's Name
First
Last
Additional Guardian's Phone
Emergency Contact
(Required)
First
Last
Emergency Contact's Phone
Are you interested in coaching?
Yes
No
I would like to volunteer as
Coach
Assistant Coach
Will you sponsor a team
Yes
No
Sponsor Name
Would you like the child to be placed up one age group?
Yes
No
Initial here that you approve your child being placed up one age group.
Waiver
(Required)
CITY OF ROANOKE, ALABAMA In consideration of my child and/or child over whom I have guardianship or custody being permitted to enroll and participate in a recreation program conducted on the City of Roanoke premises, whether said program is run under the direction of the City of Roanoke or any other independent entity or persons, the undersigned agrees to the terms and conditions hereinafter stated for himself/herself, his/her child/ward, and for any other person or entity who may have custody of or personal responsibility for the child. The undersigned further agrees and represents they have had the opportunity to inspect and carefully consider the premises and facilities to be utilized with the program the child named above is to participate in. The undersigned further acknowledges and understands that they have been given the opportunity to ask any questions concerning the program and to question and discuss participation in the program with any coach or other person associated of the program. The undersigned in signing this agreement acknowledges they are satisfied with all the facilities and premises to be utilized with the program the child is participating in and they are satisfied that they fully understand the nature of the program and those persons who will be responsible for coaching or participating in any way with the above named child concerning the program. The undersigned has been further given the opportunity to inspect all facilities and equipment associated or affiliated with the program to be participated in by the above child and the undersigned finds and accepts that the same is safe and reasonably suited for the purposes of the program for which the child will participate. The program for which the above child desires will be enrolled or desires to participate is (sport/activity/program). In consideration of being permitted to participate in the aforementioned program and all activities associated with the same, the undersigned agrees to the following on behalf of the undersigned and the undersigned’s child/ward or child who the undersigned has legal responsibility for and on behalf of any other parent or guardian of the child/ward named above: 1. The undersigned hereby releases, waives, discharges, and covenants not to sue the City of Roanoke, its officers, employees, agents, coaches, team managers, or volunteer assistants of the City of Roanoke Recreation Department (hereinafter referred to as “Releasees”) from all liability to the undersigned and the undersigned’s child/ward, his/her personal representatives, assigns, heirs, and next of kin for any loss or damage and any claims or demands therefor on account of injury to the person or property or resulting in the death of the undersigned or the undersigned’s child/ward, whether caused by the negligence of Releasees or otherwise while the undersigned is in, upon or about the premises or any facilities or equipment therein, or participating in any program affiliated with the City without respect to location to include transportation associated with said activities. 2. The undersigned and the undersigned on behalf of his child/ward and any other parent or guardian of the undersigned’s child/ward hereby agrees to indemnify and save and hold harmless the Releasees and each of them from any loss, liability, damage or cost they may incur due to the presence of the undersigned or the undersigned’s child/ward in, upon or about the City premises or in any way observing or using any facilities or equipment of the City or participating in any program affiliated with the City, whether caused by the negligence of the Releasees or otherwise. 3. The undersigned and the undersigned on behalf of his/her child/ward and any other parent or guardian of the undersigned’s child/ward hereby assumes full responsibility for and risk of bodily injury, death or property damage due to negligence of Releasees or otherwise while in, about or upon the premises of the City and/or while using the premises or any facilities or equipment or participating in any program affiliated with the City program. 4. The undersigned and the undersigned on behalf of his/her child/ward and any other parent or guardian of the undersigned’s child/ward hereby agrees to abide by the City of Roanoke Recreation Department Ejection, Suspension, and Conduct Policy which is available from the Recreation Department Director. 5. The undersigned and the undersigned on behalf of his/her child/ward and any other parent or guardian of the undersigned’s child/ward hereby agrees to allow photographs to be taken of them and used in advertising and promotion by the City of Roanoke Recreation Department. 6. The undersigned and the undersigned on behalf of his/her child/ward and any other parent or guardian of the undersigned’s child/ward hereby agrees to allow Releases to obtain and authorize medical care for themselves and their child/ward at any hospital, emergency medical center, or any other health facility by any medical doctor, osteopath, nurse, surgeon, or any other medical provider. The undersigned and the undersigned on behalf of his/her child/ward and any other parent or guardian of the undersigned’s child/ward hereby expressly agrees to be responsible for the payment of any and all medical expenses incurred by the undersigned and the undersigned’s child/ward and any other parent or guardian of the undersigned’s child/ward and to hold Releasee authorizing the medical care harmless from any payment of medical expenses incurred as a result of the medical care authorized. 7. The undersigned and the undersigned on behalf of his/her child/ward and any other parent or guardian of the undersigned’s child/ward hereby agrees to return all equipment that is property of the City of Roanoke Recreation Department within two (2) weeks of the final game. If said equipment is not returned the City of Roanoke Recreation Department may deny registration to any other sport and may pursue other legal action for the collection of the value of the equipment not returned. 8. The undersigned further expressly agrees that the foregoing release, waiver and indemnity agreement is intended to be as broad and inclusive as is permitted by the laws of the State of Alabama, and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. 9. The undersigned has read and voluntarily signed the release and waiver of liability and indemnity agreement and further agrees that no oral representations, statements or inducement apart from the foregoing written agreement have been made, and the undersigned has authority to execute this document on behalf of the undersigned’s child/ward and any other parent or guardian of the undersigned’s child/ward.
I consent.
Birth Certificate Upload
(Required)
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Max. file size: 300 MB, Max. files: 1.
Sign-ups
First Name
(Required)
Last Name
(Required)
Which Sport?
Basketball
To be paired with a sibling, the children must reside in the same household. Pair with sibling
(Required)
Paired
Yes
No
Sibling's Name to be paired with
First
Last
Address
(Required)
Street Address
City
State / Province / Region
ZIP / Postal Code
Phone
(Required)
Email
(Required)
Age
(Required)
Please enter a number from
2
to
99
.
Gender
(Required)
Male
Female
Sport
(Required)
Date of Birth
(Required)
MM
1
2
3
4
5
6
7
8
9
10
11
12
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
YYYY
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Height
(Required)
Weight
(Required)
Shirt Size
(Required)
Youth XS
Youth S
Youth M
Youth L
Youth XL
Youth 2XL
Youth 3XL
Adult Extra Small
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2XL
Adult 3XL
Adult 4XL
Pants Size
(Required)
Youth XS
Youth S
Youth M
Youth L
Youth XL
Youth 2XL
Youth 3XL
Adult Extra Small
Adult Small
Adult Medium
Adult Large
Adult XL
Adult XXL
Adult 3XL
Adult 4XL
Last Year's Team
Jersey Number (choose up to three options)
(Required)
Guardian's Name
(Required)
First
Last
Guardian's Phone
(Required)
Additional Guardian's Name
First
Last
Additional Guardian's Phone
Emergency Contact
(Required)
First
Last
Emergency Contact's Phone
Are you interested in coaching?
Yes
No
I would like to volunteer as
Coach
Assistant Coach
Will you sponsor a team
Yes
No
Sponsor Name
Would you like the child to be placed up one age group?
Yes
No
Initial here that you approve your child being placed up one age group.
Waiver
(Required)
CITY OF ROANOKE, ALABAMA In consideration of my child and/or child over whom I have guardianship or custody being permitted to enroll and participate in a recreation program conducted on the City of Roanoke premises, whether said program is run under the direction of the City of Roanoke or any other independent entity or persons, the undersigned agrees to the terms and conditions hereinafter stated for himself/herself, his/her child/ward, and for any other person or entity who may have custody of or personal responsibility for the child. The undersigned further agrees and represents they have had the opportunity to inspect and carefully consider the premises and facilities to be utilized with the program the child named above is to participate in. The undersigned further acknowledges and understands that they have been given the opportunity to ask any questions concerning the program and to question and discuss participation in the program with any coach or other person associated of the program. The undersigned in signing this agreement acknowledges they are satisfied with all the facilities and premises to be utilized with the program the child is participating in and they are satisfied that they fully understand the nature of the program and those persons who will be responsible for coaching or participating in any way with the above named child concerning the program. The undersigned has been further given the opportunity to inspect all facilities and equipment associated or affiliated with the program to be participated in by the above child and the undersigned finds and accepts that the same is safe and reasonably suited for the purposes of the program for which the child will participate. The program for which the above child desires will be enrolled or desires to participate is (sport/activity/program). In consideration of being permitted to participate in the aforementioned program and all activities associated with the same, the undersigned agrees to the following on behalf of the undersigned and the undersigned’s child/ward or child who the undersigned has legal responsibility for and on behalf of any other parent or guardian of the child/ward named above: 1. The undersigned hereby releases, waives, discharges, and covenants not to sue the City of Roanoke, its officers, employees, agents, coaches, team managers, or volunteer assistants of the City of Roanoke Recreation Department (hereinafter referred to as “Releasees”) from all liability to the undersigned and the undersigned’s child/ward, his/her personal representatives, assigns, heirs, and next of kin for any loss or damage and any claims or demands therefor on account of injury to the person or property or resulting in the death of the undersigned or the undersigned’s child/ward, whether caused by the negligence of Releasees or otherwise while the undersigned is in, upon or about the premises or any facilities or equipment therein, or participating in any program affiliated with the City without respect to location to include transportation associated with said activities. 2. The undersigned and the undersigned on behalf of his child/ward and any other parent or guardian of the undersigned’s child/ward hereby agrees to indemnify and save and hold harmless the Releasees and each of them from any loss, liability, damage or cost they may incur due to the presence of the undersigned or the undersigned’s child/ward in, upon or about the City premises or in any way observing or using any facilities or equipment of the City or participating in any program affiliated with the City, whether caused by the negligence of the Releasees or otherwise. 3. The undersigned and the undersigned on behalf of his/her child/ward and any other parent or guardian of the undersigned’s child/ward hereby assumes full responsibility for and risk of bodily injury, death or property damage due to negligence of Releasees or otherwise while in, about or upon the premises of the City and/or while using the premises or any facilities or equipment or participating in any program affiliated with the City program. 4. The undersigned and the undersigned on behalf of his/her child/ward and any other parent or guardian of the undersigned’s child/ward hereby agrees to abide by the City of Roanoke Recreation Department Ejection, Suspension, and Conduct Policy which is available from the Recreation Department Director. 5. The undersigned and the undersigned on behalf of his/her child/ward and any other parent or guardian of the undersigned’s child/ward hereby agrees to allow photographs to be taken of them and used in advertising and promotion by the City of Roanoke Recreation Department. 6. The undersigned and the undersigned on behalf of his/her child/ward and any other parent or guardian of the undersigned’s child/ward hereby agrees to allow Releases to obtain and authorize medical care for themselves and their child/ward at any hospital, emergency medical center, or any other health facility by any medical doctor, osteopath, nurse, surgeon, or any other medical provider. The undersigned and the undersigned on behalf of his/her child/ward and any other parent or guardian of the undersigned’s child/ward hereby expressly agrees to be responsible for the payment of any and all medical expenses incurred by the undersigned and the undersigned’s child/ward and any other parent or guardian of the undersigned’s child/ward and to hold Releasee authorizing the medical care harmless from any payment of medical expenses incurred as a result of the medical care authorized. 7. The undersigned and the undersigned on behalf of his/her child/ward and any other parent or guardian of the undersigned’s child/ward hereby agrees to return all equipment that is property of the City of Roanoke Recreation Department within two (2) weeks of the final game. If said equipment is not returned the City of Roanoke Recreation Department may deny registration to any other sport and may pursue other legal action for the collection of the value of the equipment not returned. 8. The undersigned further expressly agrees that the foregoing release, waiver and indemnity agreement is intended to be as broad and inclusive as is permitted by the laws of the State of Alabama, and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. 9. The undersigned has read and voluntarily signed the release and waiver of liability and indemnity agreement and further agrees that no oral representations, statements or inducement apart from the foregoing written agreement have been made, and the undersigned has authority to execute this document on behalf of the undersigned’s child/ward and any other parent or guardian of the undersigned’s child/ward.
I consent.
Birth Certificate Upload
(Required)
Drop files here or
Select files
Max. file size: 300 MB, Max. files: 1.
Basketball
First Name
(Required)
Last Name
(Required)
Which Sport?
Basketball
To be paired with a sibling, the children must reside in the same household. Pair with sibling
(Required)
Paired
Yes
No
Sibling's Name to be paired with
First
Last
Address
(Required)
Street Address
City
State / Province / Region
ZIP / Postal Code
Phone
(Required)
Email
(Required)
Age
(Required)
Please enter a number from
2
to
99
.
Gender
(Required)
Male
Female
Sport
(Required)
Date of Birth
(Required)
MM
1
2
3
4
5
6
7
8
9
10
11
12
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
YYYY
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Height
(Required)
Weight
(Required)
Shirt Size
(Required)
Youth XS
Youth S
Youth M
Youth L
Youth XL
Youth 2XL
Youth 3XL
Adult Extra Small
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2XL
Adult 3XL
Adult 4XL
Pants Size
(Required)
Youth XS
Youth S
Youth M
Youth L
Youth XL
Youth 2XL
Youth 3XL
Adult Extra Small
Adult Small
Adult Medium
Adult Large
Adult XL
Adult XXL
Adult 3XL
Adult 4XL
Last Year's Team
Jersey Number (choose up to three options)
(Required)
Guardian's Name
(Required)
First
Last
Guardian's Phone
(Required)
Additional Guardian's Name
First
Last
Additional Guardian's Phone
Emergency Contact
(Required)
First
Last
Emergency Contact's Phone
Are you interested in coaching?
Yes
No
I would like to volunteer as
Coach
Assistant Coach
Will you sponsor a team
Yes
No
Sponsor Name
Would you like the child to be placed up one age group?
Yes
No
Initial here that you approve your child being placed up one age group.
Waiver
(Required)
CITY OF ROANOKE, ALABAMA In consideration of my child and/or child over whom I have guardianship or custody being permitted to enroll and participate in a recreation program conducted on the City of Roanoke premises, whether said program is run under the direction of the City of Roanoke or any other independent entity or persons, the undersigned agrees to the terms and conditions hereinafter stated for himself/herself, his/her child/ward, and for any other person or entity who may have custody of or personal responsibility for the child. The undersigned further agrees and represents they have had the opportunity to inspect and carefully consider the premises and facilities to be utilized with the program the child named above is to participate in. The undersigned further acknowledges and understands that they have been given the opportunity to ask any questions concerning the program and to question and discuss participation in the program with any coach or other person associated of the program. The undersigned in signing this agreement acknowledges they are satisfied with all the facilities and premises to be utilized with the program the child is participating in and they are satisfied that they fully understand the nature of the program and those persons who will be responsible for coaching or participating in any way with the above named child concerning the program. The undersigned has been further given the opportunity to inspect all facilities and equipment associated or affiliated with the program to be participated in by the above child and the undersigned finds and accepts that the same is safe and reasonably suited for the purposes of the program for which the child will participate. The program for which the above child desires will be enrolled or desires to participate is (sport/activity/program). In consideration of being permitted to participate in the aforementioned program and all activities associated with the same, the undersigned agrees to the following on behalf of the undersigned and the undersigned’s child/ward or child who the undersigned has legal responsibility for and on behalf of any other parent or guardian of the child/ward named above: 1. The undersigned hereby releases, waives, discharges, and covenants not to sue the City of Roanoke, its officers, employees, agents, coaches, team managers, or volunteer assistants of the City of Roanoke Recreation Department (hereinafter referred to as “Releasees”) from all liability to the undersigned and the undersigned’s child/ward, his/her personal representatives, assigns, heirs, and next of kin for any loss or damage and any claims or demands therefor on account of injury to the person or property or resulting in the death of the undersigned or the undersigned’s child/ward, whether caused by the negligence of Releasees or otherwise while the undersigned is in, upon or about the premises or any facilities or equipment therein, or participating in any program affiliated with the City without respect to location to include transportation associated with said activities. 2. The undersigned and the undersigned on behalf of his child/ward and any other parent or guardian of the undersigned’s child/ward hereby agrees to indemnify and save and hold harmless the Releasees and each of them from any loss, liability, damage or cost they may incur due to the presence of the undersigned or the undersigned’s child/ward in, upon or about the City premises or in any way observing or using any facilities or equipment of the City or participating in any program affiliated with the City, whether caused by the negligence of the Releasees or otherwise. 3. The undersigned and the undersigned on behalf of his/her child/ward and any other parent or guardian of the undersigned’s child/ward hereby assumes full responsibility for and risk of bodily injury, death or property damage due to negligence of Releasees or otherwise while in, about or upon the premises of the City and/or while using the premises or any facilities or equipment or participating in any program affiliated with the City program. 4. The undersigned and the undersigned on behalf of his/her child/ward and any other parent or guardian of the undersigned’s child/ward hereby agrees to abide by the City of Roanoke Recreation Department Ejection, Suspension, and Conduct Policy which is available from the Recreation Department Director. 5. The undersigned and the undersigned on behalf of his/her child/ward and any other parent or guardian of the undersigned’s child/ward hereby agrees to allow photographs to be taken of them and used in advertising and promotion by the City of Roanoke Recreation Department. 6. The undersigned and the undersigned on behalf of his/her child/ward and any other parent or guardian of the undersigned’s child/ward hereby agrees to allow Releases to obtain and authorize medical care for themselves and their child/ward at any hospital, emergency medical center, or any other health facility by any medical doctor, osteopath, nurse, surgeon, or any other medical provider. The undersigned and the undersigned on behalf of his/her child/ward and any other parent or guardian of the undersigned’s child/ward hereby expressly agrees to be responsible for the payment of any and all medical expenses incurred by the undersigned and the undersigned’s child/ward and any other parent or guardian of the undersigned’s child/ward and to hold Releasee authorizing the medical care harmless from any payment of medical expenses incurred as a result of the medical care authorized. 7. The undersigned and the undersigned on behalf of his/her child/ward and any other parent or guardian of the undersigned’s child/ward hereby agrees to return all equipment that is property of the City of Roanoke Recreation Department within two (2) weeks of the final game. If said equipment is not returned the City of Roanoke Recreation Department may deny registration to any other sport and may pursue other legal action for the collection of the value of the equipment not returned. 8. The undersigned further expressly agrees that the foregoing release, waiver and indemnity agreement is intended to be as broad and inclusive as is permitted by the laws of the State of Alabama, and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. 9. The undersigned has read and voluntarily signed the release and waiver of liability and indemnity agreement and further agrees that no oral representations, statements or inducement apart from the foregoing written agreement have been made, and the undersigned has authority to execute this document on behalf of the undersigned’s child/ward and any other parent or guardian of the undersigned’s child/ward.
I consent.
Birth Certificate Upload
(Required)
Drop files here or
Select files
Max. file size: 300 MB, Max. files: 1.