FAX ENTRY FORM

HOOPFEST Entry Form

USE THIS FORM FOR TO ENTER BY FAX OR MAIL.
Please enter all information on this form.
When form is complete, print and sign where signature is required and mail check, money order or credit card payment to:

HOOPFEST
400 North Van Buren • Little Rock, AR 72205
You can fax your entry form if you are paying by credit card. Just fax this sheet to (501) 221-1832

Entry Fees & Deadlines
SPECIAL ENTRY FEE FOR KIDS GRADES 1st-8th. . . . . $80
All Other Participants: (High School & Adults)
$94 If received by May 21, 2010
$99 If received after May 30 but before June 1
$120 For any team received after June 2 - June 8

Player changes for any reason will cost $25. For all player changes call 501-960-4667.
All Player Changes Must Be Paid Either By Credit Card Or Cash
Prior To The Registration Party On June 11, 2010.

AMOUNT ENCLOSED:

Visa Mastercard American Express (check one)

Card # Exp. Date

Signature ___________________________________________________________________

Enter name as shown on card

Rate your Team! Check One

	TOP GUN	College experience or better
	ADULT	Oldest is out of High School
	MASTER	Over 45 years of age
	HIGH SCHOOL	Oldest Player is entering Grades 9-12
	YOUTH	Oldest Player is entering Grades 1-8

Team Name:

CAPTAIN	Male Female
Name
Address
City
State	Zip
Day Phone	-- Evening Phone --

Experience: (Please check your highest playing level)

Mjr. College: Div I Div II
Sm. College: Div III/NAIA Jr. College
College Intramurals
AAU Age Group

Varsity - High School

Age
Height
Weight

Jr. Varsity - High School

Freshman - High School

Jr. High / Middle School

Current School Grade (1-12) Current School Grade (2-12)

T-Shirt Size (Adult Sizes Only) SMALL MEDIUM LARGE XL XXL
E-Mail Address

Player's Signature:

__________________________________________________________

Parent or Guardian's Signature:

__________________________________________________________
(Required if applicant is under 18 years old)

PLAYER 2	Male Female
Name
Address
City
State	Zip
Day Phone	-- Evening Phone --

Experience: (Please check your highest playing level)

PLAYER 3	Male Female
Name
Address
City
State	Zip
Day Phone	-- Evening Phone --

Experience: (Please check your highest playing level)

PLAYER 4	Male Female
Name
Address
City
State	Zip
Day Phone	-- Evening Phone --

Experience: (Please check your highest playing level)

In consideration of your acceptance of this entry, I, intending to be legally bound, hereby, for myself, heirs, executors and administrators, waive and release HOOPFEST, its sponsors, its board of directors and any co-sponsors and their respective representatives, successors and assigns from any and all rights and claims for damages I may have arising out of any injuries and illnesses suffered by me in this event, regardless of how such injury or illness may arise and even if such illness or injury is caused by the negligence of such parties. I attest and verify that I will participate in this event as a basketball player, that I am physically fit and have sufficiently trained for competing in this event. Furthermore, I hereby grant full permission to any and all of the aforementioned to use my name and any photographs, videotapes, motion pictures, recordings or any other record of me participating in this event for any purposes without obligation or liability to me.