The Lisbon Town Recreation Department has announced signups for its 2012-2013 Winter Basketball Program for grades K-6th. Registrations will be held on Saturday November 10th from 9:30 a.m. to 11:00 a.m. and Thursday November 15th from 5:30 p.m. to 7:00 p.m. at the Town Hall.
The program offers sessions for grades K-6th grade: biddy basketball for K-2nd grades ($5 registration fee), 3rd -4th grades ($5 registration fee), and separate travel teams for boys and girls in 5th and 6th grade ($10 registration fee).
Anyone wishing to sign up can send completed application with fee by November 24th to Tori Richardson- Lampett at 311 Wood Road Lisbon, NY 13658. Please make checks payable to Lisbon Town Clerk. Payment must accompany form for the child to be placed on a team. Any questions please call Tori Lampett at 854-1946. Additional forms available at www.lisbontownrec.com.
Boys & Girls Winter Basketball Program 2012-2013 Grades K-6th
Sponsored by Lisbon Town Recreation
Please make checks payable to Lisbon Town Clerk
Send completed application with fee by November 24th to
Tori Richardson-Lampett 311 Wood Road Lisbon, NY 13658
Payment must accompany form for your child to be placed on a team.
Please check the level your child will participate in:
______ K-2nd Grade Biddy Basketball (Co-Ed) - $5.00 (starting Jan. 13)
______ 3rd-4th Grade Biddy Basketball - $5.00 (starting Jan. 13)
______ Boys Travel Team- $10.00 (5th-6th grade)
______ Girls Travel Team - $10.00 (5th-6th grade)
$25.00 Family Limit
REGISTRATION FORMS MUST BE RECEIVED BY FRIDAY NOVEMBER 24th.
PLEASE NOTE: There will be separate travel teams for 5th and 6th grade boys and girls. We will allow 4th graders to move up if requested and/or needed to complete a team. Additional forms available at www.lisbontownrec.com
Players Name: ____________________ Age: ______ Date of Birth: ____
Address: ___________________________ Grade:__________________
Parent Contact Name: _________________ Parent Contact #:__________
Email Address: ______________________________________________
WAIVER AND RELEASE: In consideration of the acceptance of this application, we the undersigned for ourselves, our heirs, executors and administrators agree to be legally bound to the terms and conditions herein after set forth:
I hereby give our consent and approval for the participation of the applicant in the program conducted by the Lisbon Recreation Department and certifies that he/she is physically fit to take part in all activities.
Further, we do hereby waive, release and forever discharge said organization, its staff, representatives, employees and their successors and assigns from any and all claims for damages occurring during the applicants participation in the soccer program, whether said accident, injury or loss due to negligence or not.
I, _______________________________(parent guardian), give my permission for
to participate in the Winter Basketball program sponsored by the Town Recreation Committee. All registration forms received after November 24th, 2012 will be assigned to teams based on the number of participants each team has.
Please list all medical problems or allergies:
Signed: __________________________ Date: ______________________
Payment Received:____Cash:____Check #_____
Are you interested in volunteering?____ Coach Assist.Coach Time/Score Keeper Referee