OCPR Basketball Registration
Step 1 of 3: Submit
Player's Name
*
Player's Birthday
*
Player's Age
*
Player's Grade
*
Select an option:
K
1
2
3
4
5
6
7
8
9
10
11
12
Select one
*
Select an option:
Basketball
Cheer
Jersey Size
*
Select an option:
YS (6-8)
YM (10-12)
YL (14-16)
AS
AM
AL
AXL
Shirt size- CHEER ONLY
YS
YM
YL
AS
AM
AL
Short size- CHEER ONLY
YS
YM
YL
AS
AM
AL
Player's Parent/Guardian Name(s)
*
Parent/Guardian Phone Numer
*
Player's Address
*
Parent Volunteer
*
Select an option:
No
Coach K-1st grade
Coach 2nd-3rd grade
Coach 4th-5th grade
Coach 6th-8th grade
Coach High School
Cheerleading coach
Asst. Coach basketball
Asst. Coach cheer
CONSENT FOR EMERGENCY TREATMENT in the event I cannot be contacted in a medical emergency involving
my child, I authorize the Owen County Parks and Recreation to consent to all emergency medical care
proceedings to be rendered by a duly licensed health care provder or physician. I understand that the Owen
County Parks and Recreation does not provide insurance coverage for the above listed proram participant and
that I am responsible for my child's own personal insurance coverage. This care may be given under whatever
conditions necessary for the health and well being of my child
CONSENT FOR EMERGENCY TREATMENT
*
Select an option:
I agree
I disagree
Insurance Information: Company Name
*
I agree that the Owen County Park and Recreation shall not be responsible for any personal injuries or
losses sustained by me or my registered child while on any premises, or as a result of any Owen County
Park and Recreation sponsored activities. I further agree to indemnify and save harmless the Owen
County Park and Recreation from any claims or demands arising out of any such injuries or losses.
Proof of insurance must be provided:
Insurance information: Policy#
*
I understand that the fee must accompany the registration form for my child to be placed on the team
*
Select an option:
I agree
I disagree
This registration is for the first two registrations in the SAME household. Each additional registration is $25. To complete any additional registrations contact Courtney Roberts. 502-751-2211
Registration Fees
*
Select an option:
Basketball- ($75 USD)
Cheer- ($75 USD)
Additional child in household- ($25 USD)
By Signing this form you are agreeing to the above waivers, policies and certifying information to be correct to the best of your knowledge.
Signature
*
Date:
Wednesday, 1 April 2026 (EDT)
Name:
Type your name to sign this document:
Typing name is equivalent to a handwritten signature
Scan this QR code with your phone:
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