3 on3 For Chinatown

Saturday, June 16, 2012 | supportLAchinatown.org

Third annual basketball tournament supporting scholarships for local community youth playing in Alpine Recreation Centers basketball leagues When: Saturday, June 16, 8:00am4:00pm Where: First Chinese Baptist Church Gym (949 Yale Street, Los Angeles) Sponsor: First Chinese Baptist Church Outreach Ministry

Tournament Divisions & Rates

Team Division Advanced 18+ years old Intermediate 18+ years old Youth 9th12th grade Recreation Just for fun (no playoffs)

Early-bird
April 15May 17

May 18May 31

Regular

$75*/team $75*/team $40*/team $55*/team

$90*/team $90*/team $50*/team $65*/team

*Add $10 for 4th player Spots are limited, so register early! T-shirt and lunch included for all registered players. Awards will be given to the champs of each division (except Recreation). Individual contest 3-point Shootout Sign up at the tournament $10/person

Donation Goals
1. Get Others Involved 2. More Ways to Win 3. 100% Support
To help spread the word and cover your registration fees, ask your friends and family for donations. For more details and tips, visit our website. Give beyond the registration fee. Special awards will be given to the top teams who raise the largestamounts.

All proceeds go to scholarships for Alpine Recreation Centers youth basketball leagues and are tax deductible.

For more info: supportLAchinatown.org | info@supportLAchinatown.org | 213.260.0062

3 on3 For Chinatown Youth Registration Form

Waiver Waiver: I hereby release and waive any liability against First Chinese Baptist Church, Los Angeles, hereinafter called FCBC, its officers, employees, members, and volunteers, for any injury that my child may incur as a result of his/her participation in the 3on3 For Chinatown basketball tournament, hereinafter called The Tournament, on Saturday, June 16, 2012. Medical Information
Do you have health insurance? No Yes Policy Number: Name of the Health Insurance Company: Health Information: Has your child had any of the following? (select all that apply) Frequent or severe headaches Asthma Ear, nose, or throat trouble Heart trouble List any allergies and/or allergic reactions: List any medication your child now takes: Dizziness or fainting spells Frequent colds Shortness of breath Diabetes

Should it be necessary for my child to have medical treatment while participating in The Tournament, I hereby give the person(s) in charge permission to act on my behalf to secure medical services or hospitalization deemed necessary and appropriate by the physician. I absolve FCBC, its personnel, and its corporate officers, from any and all forms of negligence and wrong treatment incurred in the procurement and process of hospitalization and medical treatment. Any cost incurred shall be my sole responsibility. Code Of Conduct: I agree that good sportsmanship and cooperation is both anticipated and expected. Poor sportsmanship could result in penalties against the team. Failure to comply with the spirit of The Tournament, with foul language and acts such as fighting, taunting, intimidating, or verbally attacking a Tournament official, player or spectator may lead to removal of that player, team and/or spectator from The Tournament. Use of tobacco, drugs, or alcohol or possession of any weapons on FCBC premises is not allowed. Decisions made by Tournament officials are final. Media Release: I agree that FCBC may use any type of audio and/or visual records of this program for its promotional and/or commercial purposes without compensation to me. Acknowledgment of Understanding: I have read this waiver of liability, code of conduct and media release agreement and fully understand its terms. I acknowledge that I am signing the agreement freely and voluntarily, and intend by my signature to be a complete and unconditional release of all liability.

Participant Information
Phone: Division: (select one) Youth Email: Recreation T-shirt Size: (select one) S M L XL

Team Name: Team Captains Name: How did you hear about this event? (select all that apply) Friend Facebook Email Flyer/Poster Sunday bulletin

 Participants Full Name Participants Signature Age Parent/Guardians Full Name Parent/Guardians Signature Relationship to Participant Home Phone

 Date

Registration Checklist
Complete this entire form, including all necessary signatures. Make any check out to FCBC with 3on3 Outreach in the memo line (add $10 to the registration rate for a 4th player). Place all your teams registration forms and payment in one envelope, and return to ChristianaWong or mail to (no cash if mailed): First Chinese Baptist Church ATTN: Spencer Sun 942 Yale Street, Los Angeles, CA 90012

 Parent/Guardians Mobile Phone

 Address City

Complete registration form and payment are required to secure tournament spot, subject to space availability. All payments are final.
Cash Check #: Received By:  Rev 05/2012

Official Use Only Date Received:

Amount:$