Please check the tournament date below and circle the

Bring Your Game to Canada’s Premier Multi-Court Basketball Only Facility.

HoopDome OBA Tournament(s) Club Name: __________________________________ Please check the tournament date below and circle the appropriate level:

Dates                  

Feb. 2 – 4, 2018 Feb. 2 – 4, 2018 Feb. 2 – 4, 2018 Feb. 16 – 18, 2018 Feb. 16 – 18, 2018 Mar. 2 – 4, 2018 Mar. 2 – 4, 2018 Mar. 2 – 4, 2018 Mar. 9 – 11, 2018 Mar. 9 – 11, 2018 Mar. 30 – Apr, 1, 2018 Mar. 30 – Apr. 1, 2018 Apr. 6 – 8, 2018 Apr. 6 – 8, 2018 Apr. 13 – 15, 2018 Apr. 13 – 15, 2018 Apr. 27 – 29, 2018 Apr. 27 – 29, 2018

Division

Level (please indicate by circling)

U 10 Novice Boys U 12 Major Atom Boys U 14 Major Bantam Girls U 15 Midget Girls U 16 Major Midget Girls U 10 Novice Girls U 11 Atom Girls U 12 Major Atom Girls U 11 Atom Boys U 13 Bantam Girls U 13 Bantam Boys U 14 Major Bantam Boys U 15 Midget Boys U 16 Major Midget Boys U 17 Juvenile Boys U 19 Junior Boys U 17 Juvenile Girls U 19 Junior Girls

A/AA A/AA A/AA A/AA A/AA A/AA A/AA A/AA A/AA A/AA A/AA A/AA A/AA A/AA A/AA A/AA A/AA A/AA

and and and and and and and and and and and and and and and and and and

AA/AAA AA/AAA AA/AAA AA/AAA AA/AAA AA/AAA AA/AAA AA/AAA AA/AAA AA/AAA AA/AAA AA/AAA AA/AAA AA/AAA AA/AAA AA/AAA AA/AAA AA/AAA

Please provide us with the following information regarding the Team’s Primary Contact (Head Coach) Name:

_____________________________________

Email: ______________________________________

Phone:

___________________________

□ Work

□ Home

□ Cell

Address: __________________________________________________________________ City, Province, Postal Code: __________________________________________________ Payment - Please Print Clearly

I will be paying by: □ Cash

All cheques are payable to HoopDome Inc.

□ Cheque#

□ MasterCard

Amount: $486.73 + $63.27 HST (13%) = Total: $550.00 Card #: Full Name that appears on the card:

□ Visa

□ EFT (password: hoopdome)

-

EXP

-

Card Holder Signature:

After reading the waiver below, please check the box below indicating that you read, understand and agree. □ I have read, understand and agree to the policies on the waiver below. Date: ________________________ Cancellation/Refund Policy: A written request to withdraw from a program must be received in writing to the HoopDome office two weeks prior to the start date of the program. There is a $25.00 administration fee for all refunds. ABSOLUTELY NO refunds two weeks prior to the start of the tournament. Waiver: I hereby give my consent for the above mentioned team to play basketball under the auspices of HoopDome and to abide by the rules of HoopDome. Such rules outline the HoopDome policy in such areas as registration, refunds, administration of programs, playing rules, and by-laws and regulations. I hereby give my consent for any player’s picture or name to be used in any HoopDome publications necessary. I will remain responsible for the player during, to and from all HoopDome activities and I agree that the HoopDome team/game officials shall in no event be held liable or accused of negligence or any other charges. I hereby agree to hold harmless HoopDome, team and game officials from any claim or lawsuit. I understand that completion and submission of this application and receipt by HoopDome will bind the above named individual to HoopDome for the entire basketball season for which I am registering.

HoopDome 75 Carl Hall Road, Unit #17, Toronto, Ontario M3K 2B9 Tel: 416-633-HOOP (4667), Fax: 416-633-8118 Email: [email protected] Official Website: www.hoopdome.com

Bring Your Game to Canada’s Premier Multi-Court Basketball Only Facility.

TEAM ROSTER Club Name: Coach’s Name:

Coach’s Contact:

NAME

Team Captain 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12.

Cancellation/Refund Policy: A written request to withdraw from a program must be received in writing to the HoopDome office two weeks prior to the start date of the program. There is a $25.00 administration fee for all refunds. ABSOLUTELY NO refunds two weeks prior to the start of the tournament. Waiver: I hereby give my consent for the above mentioned team to play basketball under the auspices of HoopDome and to abide by the rules of HoopDome. Such rules outline the HoopDome policy in such areas as registration, refunds, administration of programs, playing rules, and by-laws and regulations. I hereby give my consent for any player’s picture or name to be used in any HoopDome publications necessary. I will remain responsible for the player during, to and from all HoopDome activities and I agree that the HoopDome team/game officials shall in no event be held liable or accused of negligence or any other charges. I hereby agree to hold harmless HoopDome, team and game officials from any claim or lawsuit. I understand that completion and submission of this application and receipt by HoopDome will bind the above named individual to HoopDome for the entire basketball season for which I am registering.

HoopDome 75 Carl Hall Road, Unit #17, Toronto, Ontario M3K 2B9 Tel: 416-633-HOOP (4667), Fax: 416-633-8118 Email: [email protected] Official Website: www.hoopdome.com