Team Roster and
Waiver Form
	NorthWest Beltway Basketball League
A Division of the Pikesville Recreation & Parks Council
This roster must be turned in to the League Office prior to 
the team’s first game. If not, all games played before roster is turned in will not count.	•	Tournament
•	Winter League
•	Spring League
Date: _____________	
_________________________________________________________________________________________________________________________________________________________________

PARENT’S WAIVER: I, the undersigned parent, certify that my child, named adjacent to my signature, has my permission to participate in the games and related activities of the NorthWest Beltway Basketball League. I acknowledge and understand that basketball is a dangerous sport and that there is a possibility of injury to my child. In consideration for my child’s participation in the game of basketball, I hereby release, acquit and forever discharge indemnity, and hold harmless from any and all claims, demands, actions or causes of action for liability for damages arising out of, or in any way related to, my child’s participation in basketball play, including tournament play, the NorthWest Beltway Basketball League, the Pikesville Recreation & Parks Council, and all of its coaches, tournament representatives, officers, directors, employees, agents, volunteers and representatives.
NOTICE: The leagues and tournaments, which the Pikesville Recreation & Parks Council operates, do not supply any form of medical coverage. ALL PARTICIPANTS PLAY AT THEIR OWN RISK.
THIS AUTHORIZATION IS IN EFFECT FOR A PERIOD OF ONE (1) SEASON OR TOURNAMENT FROM THE DATE GIVEN.
TEAM NAME
	AGE GROUP
	ORGANIZATION                           
	
COACH CONTACT NAME
	ASSISTANT’S NAME
	
COACH/CONTACT ADDRESS
	ASSISTANT’S ADDRESS	
PHONE (H)	(W)	CELL:
	PHONE (H)	(W)	CELL:	
E-MAIL
		E-MAIL		
#	PLAYER’S NAME	ADDRESS & ZIP	D.O.B.	PARENT’S SIGNATURE	DATE	

						

						

						

						

						

						
Roster Maximum for basketball league and tournament play is 12 players