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Welcome to the Program for the 2019-20 Season. 

MEMBERSHIP REGISTRATION

CLUB DUES \ INFORMATION

Club Dues Information

  • Season runs year round, starting September 1st, 2019 and ends August 31st, 2020
  • There is a one time registration fee of $50, due at the beginning of the season.
  • Monthly club due amounts will be listed below.
  • Uniforms are not included in the club fee.

Payment Options

Monthly payment is by the 1st practice of each month. If payment is not made by the 2nd practice of the month, a $10 late fee will apply.

The payment options are below:

  • Monthly dues are to be paid the 1st practice of each month. (Cash, Money Order, Credit, or Invoice)
  • Everyone will recieve a reoccuring invoice and reciepts will be send based on how the payments are paid.
  • We will not be taking personal checks
  • Cancellation requires a 30 day written notice.

Financial Assistance

Fastbreak Sports is an inclusive organization that recognizes the need to serve all members of the community, including those economically less advantaged, who are not able to pay the full cost of membership or program fees. Financial aid will be looked at on an individual case-by-case basis. The board will make the final decision.

Club Dues

1. Club Team $125 

(2) team practice/training per week 
(2) events per month. 

2. ADDITIONAL Skills Training Package $50 per month

(Days TBD) Skills trainings will be held at The LAB in Carson. Inquire with Coach Leland or Coach Lionel for more details

Uniforms

Uniforms will not be ordered without

1) a $50 deposit and pre-arranged payment plan or 2) full payment.

Uniform costs are separate from the monthly program fees described above. Currently, uniforms cost $100-$250 depending on the uniform package.

Practice/Games

All players are required to bring a basketball to practice. All players are required to clean up after themselves before leaving the gym. All bottles and/or trash must be thrown away prior to leaving. All players are required to have appropriate shoes to prevent injury during practice and/or games.

Financial Policies Contract

I, have read and understand the fee information sheet. Concerning my financial obligations with the Fastbreak Sports, I agree to be solely responsible for the payments of child's club membership dues as stipulated. I also agree to pay any late fees or damages incurred by my child. I also agree to be financially responsible for any litigation or attorney and court fees that may result from not meeting my obligations on payments for my child. I understand cancellation requires a 30-day written notice.

 

Parent/Agency Representative/Legal Guardian Signature

FASTBREAK SPORTS WAIVER RELEASE AND INDEMNITY AGREEMENT

The participant of Parent(s) if under the age of 18 must complete and return this agreement. It is understood that I (THE PARTICIPANT) cannot play, participate, join, engage, assist, serve or spectate until this waiver and indemnity form has been completed. For and in consideration of permitting (PARTICIPANT) to participate in all Fastbreak Sports activities, the undersigned acknowledge, affirms, represents, and covenants he/she is of lawful age or is the lawful guardian or participant and has the sole right and authority to execute this agreement on behalf of participant that he/she has not sold, assigned, transferred, conveyed, hypothecated or otherwise disposed of his/her right to authority. The undersigned he/she heirs, executors, administrators, successors, assigns, directors or agents herby release waive discharge and relinquish any actions or cause of action, demands, cost, loss of service expenses any compensation whatsoever which may hereafter arise for himself/herself and for his/hers heirs, executors, administrators or any other persons, firms, corporations, associations or partnerships (hereinafter referred to as "release") for any cause of action including but not limited to losses caused by the active or passive negligence of the releases.

The (PARTICIPANT) and/or undersigned acknowledges, affirms and understands and assumes all risk inherent in the above mentioned activities and all incidental activities associated therewith and said activities involve a risk of physical injury and/or death to his/her person and property and the undersigned is participating with full and complete knowledge of said risk. It is the intention of(PARTICIPANT) or the undersigned by this instrument to exempt and relieve releases from liability for personal or bodily injury, property damage and wrongful death.

The(PARTICIPANT) or undersigned, for themselves, himself/herself, his/her heirs, executors, successors, administrators or assigns agrees that in the event any claim of the participant and/or undersigned's child for person or bodily injury, property damage or wrongful death shall be prosecuted against, he/she/they, their heirs executers, administrators, successors and assigns shall partnership from and against any and all liability, suites, actions, proceedings, judgments, claims, liens, damages (whether in contract or in tort, including personal and bodily injury, death or property damage), cost and expenses, (including attorneys' fees, litigation, arbitration and medical expenses) of every nature of kind which arise from, cause by, or which are alleged from or to have been caused by, or in conjunction with, any and all acts or omissions whether negligent or otherwise.

The (PARTICIPANT) and/or undersigned acknowledge that he/she has read the forgoing and has been fully and completely advised of signing this document. Based upon their independent evaluation of the risk. I/We reaffirm my acknowledgement and express assumption of the risk and dangers set forth above.

Parent/Agency Representative/Legal Guardian Signature

November 22, 2019

PARENTAL CONSENT FOR MEDICAL TREATMENT

AS THE PARENT, AGENCY REPRESENTATIVE OR LEGAL GUARDIAN, I HEREBY GIVE CONSENT TO FASTBREAK SPORTS TO PROVIDE ALL MEDICAL CARE PRESCRIBED BY A DUTY LICENSED PHYSICIAN (M.D.) OR DENTIST (D.D.S.)

November 22, 2019

ASSUMPTION OF RISK AND INDEMNITY AGREEMENT/POLICIES

I confirm that my child is in good physical condition and that I understand the nature of the activity in which he/she will participate. In consideration of my acceptance into the program, I hereby assume all responsibility for any and all personal injuries, including death and property damage, which he/she may suffer during or as a result of his/her participation in this program. Further, for my childs personal representatives, heirs and next of kin, I release and agree to indemnify the Board of Directors, Fastbreak Sports, and/or its volunteer(s), from any and all losses, claim liabilities or damages arising out of my childs participation in this program. I have read and understand and now sign this assumption of risk, release and indemnity agreement.

Parent/Agency Representative/Legal Guardian Signature

November 22, 2019

PHOTOGRAPHIC RELEASE

I give Fastbreak Sports permission with respect to photographs, videos, motion pictures, and/or sound recordings being taken of my child to use, publish, and republish in the same, in whole or part, separately or in conjunction with other photographs or recordings. I release and discharge Fastbreak Sports from any claims and demands arising out of or in connection with the use of such photographs, videos, motion pictures and/or recordings.

Parent/Agency Representative/Legal Guardian Signature

November 22, 2019

TRANSPORTATION PERMISSION SLIP

I hereby agree to indemnify and hold harmless Fastbreak Sports, The Board of Directors and employees/volunteers and any community organization cosponsoring the program, from and against any and all liability for any injury, which may be suffered arising out of or in any way, connected with my participant in the program names above. I fully acknowledge that the children may be transported from the Fastbreak Sports meeting point and transported back to the Fastbreak Sports meeting point for all tournaments/games.

I hereby give my child, permission to attend all tournaments/games associated with Fastbreak Sports of which I have prior knowledge.

I HEREBY AGREE NOT TO HOLD FASTBREAK SPORTS, BOARD OF DIRECTORS OR VOLUNTEERS RESPONSIBLE IN ANY WAY.

Parent/Agency Representative/Legal Guardian Signature

November 22, 2019

Please select who will be participating...
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First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

Grade: *

School:

LIST ANY ALLERGIES, MEDICAL, PHYSICAL AND/OR EMOTIONAL CONDITIONS WE SHOULD KNOW ABOUT. 

PLAYER'S CODE OF ETHICS

  •  I will place my studies above athletics. 
  • I hereby pledge to show positive support for my teammates. 
  • I will show good sportsmanship to all players, coaches and officials at every games and practice. 
  • I will play to have fun but strive for success. 
  • I will remember that this is only a game. 
  • I will treat other players, coaches, visitors, and officials with respect. 
  • I will not use any foul or vulgar language at any time. 
  • If I have a problem, I will report it to my Coach, Director, board member and/ or parents before it becomes a bigger problem. 
  • I will conduct myself in a respectable manner when at home tournaments or traveling to other facilities. 
  • I understand that being part of the Fastbreak Sports Basketball Travel Team is a privilege that can be taken away for not abiding by this code of ethics. 
  • I will always exhibit the Fastbreak Sports Core Values of Caring, Honesty, Respect and Responsibility.

First Participant's Signature*
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Insurance

Insurance Carrier*

Insurance Policy Number*
FINANCIAL REQUIREMENTS - PAYMENTS

I, agree to pay Fastbreak Sports a monthly club dues starting on for the amount indicated below for membership in the Fastbreak Sports program. 

Select:

Monthly Fees: 

Registration Fee: *
$50 per player
Uniform Fee: *
$100-$250 per player depending on the package

Payments and orders cannot be placed until the completed form is received. This payment authorization is valid and to remain in effect unless I notify Fastbreak Sports of its cancellation by sending a 30 day written notice. 

PARENT'S CODE OF ETHICS

  • I hereby pledge to provide positive support, care and encouragement for my child participating in the Fastbreak Sports Basketball Travel Team by following this Parent's Code of Ethics. 
  • I will encourage good Sportsmanship by demonstrating positive support for all players, coaches and officials at every game, practice or other event. 
  • I will place the emotional and physical well being of my child ahead of a personal desire to win. 
  • I will insist that my child play in a safe and healthy environment. 
  • I will support coaches and officials who are here to provide a positive and safe environment for my child. 
  • I will keep competition and winning in perspective. 
  • I will understand and support positive encouragement for my child and all players. 
  • I will help my child to properly prepare for practice and games, by having the appropriate equipment and arriving to practices and games on time. 
  • I will help my child to focus on developing as a player and a person. 
  • I will always exhibit the Fastbreak Sports Core Value of Caring, Honestly, Respect and Responsibility.

Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Grade: *

School:

LIST ANY ALLERGIES, MEDICAL, PHYSICAL AND/OR EMOTIONAL CONDITIONS WE SHOULD KNOW ABOUT. 

PLAYER'S CODE OF ETHICS

  •  I will place my studies above athletics. 
  • I hereby pledge to show positive support for my teammates. 
  • I will show good sportsmanship to all players, coaches and officials at every games and practice. 
  • I will play to have fun but strive for success. 
  • I will remember that this is only a game. 
  • I will treat other players, coaches, visitors, and officials with respect. 
  • I will not use any foul or vulgar language at any time. 
  • If I have a problem, I will report it to my Coach, Director, board member and/ or parents before it becomes a bigger problem. 
  • I will conduct myself in a respectable manner when at home tournaments or traveling to other facilities. 
  • I understand that being part of the Fastbreak Sports Basketball Travel Team is a privilege that can be taken away for not abiding by this code of ethics. 
  • I will always exhibit the Fastbreak Sports Core Values of Caring, Honesty, Respect and Responsibility.

Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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