2020-21 CSBL REGISTRATION FORM
Please be very clear in completing this form Email completed form to:
CSBLNEWS@GMAIL.COM
Name:___________________________________________ Date of Birth:________________
Street Address:_______________________________________________________________________
City:________________________________________ State:____________ Zip______________
Home Ph.:_________________; Cell Ph.:_________________; Work Ph.:__________________
E‐mail:________________________________________________________________________
Emergency Contact Name/Relationship:____________________________________________
Emergency Contact Phone:_______________________________________________________
Emergency Medical Information (medications, medical conditions, etc): ______________________________________________________________________________
______________________________________________________________________________
Desired Status: Roster*:_______ Substitute (Wait List):_______
Desire Division: Colonie (upper):_______ Albany (lower):_______
*Note: team rosters are picked by captains, and roster eligibility is based on a player’s League Seniority Date.
YOU MUST SIGN THIS WAIVER IF YOU WISH TO PARTICIPATE IN THE LEAGUE)
I, the undersigned, agree to assume all responsibility for all risk, damage or injury that may occur to me as a result of my participation in the Colonie Senior Basketball League (CSBL).
I release and discharge, for myself, my heirs, executors, and estate administrators the CSBL, its employees, officers, directors, participants, and all persons associated with the League and all entities that own venues where CSBL games may be played, all claims, damages, of rights of action present or future which may arise in connection with my participation in the League.
Signed:_______________________________________________________ Date:___________
* * * LEAGUE USE ONLY * * * Seniority Date:__________ First Half Dues Paid:__________ Check No.:__________