UB All Stars

UB All Stars (Registration Open until Dec. 8)

October 23, 9:00 am - December 8 - 12:00 pm 2022 | University Blvd Nazarene Church

3930 University Boulevard South, Jacksonville, FL, USA

Providing the Best Sports Experience for every child.

UB All Stars gives children the opportunity to learn a sport and be part of the action through balanced talent on each team.
UB All Stars equips children with the skills needed to participate at the next level with experience that improves skills and building healthy self-confidence.
UB All Stars values sportsmanship, teamwork, integrity and respect.

Everyone must attend one basketball evaluation or cheerleading orientation.

Evaluations will take place November 19 @ 10 am and December 3 at 10 AM

Christian Heritage Academy gymnasium

3930 University Blvd. S, Jacksonville, FL 32216 on

Registration deadline is Dec. 8, 2022

Practices begin the week of January 3, 2023.

Monday practices

First game: Saturday, January 14, 2023

Awards Celebration March 4, 2023

$75.00 / participant

UB All Stars Registration

If you are a human and are seeing this field, please leave it blank.

Fields marked with an * are required

I am registering my child for.... *

Basketball
Cheerleading

I understand that the participation fee for each child is $75.

Child's First Name *

Child's Last Name *

Child's Date of Birth (mm/dd/yyyy) *

Child's Gender *

Male
Female

Current School Grade *

Address 1 *

City *

Zip / Post Code *

1st Parent/Guardian Cell *

2nd Parent/Guardian Cell

Parent/Guardian's Email

How many years has your child played organized basketball/cheer?

I would like to help by being a ....

Coach
Referee
Team Parent

If you regularly attend church, which one?

Please use this space for any special player information we should know about. (if any)

Emergency Contact Name *

Emergency Contact Phone *

Please read the Authorization and Release of Liability, Medical Condition, and Consent to Medical Treatment.

Authorization and Consent

NOTE: THIS FORM INCLUDES A RELEASE OF LIABILITY. Please review and complete the sections below and sign in the space provided to indicate your agreement with all statements made in such sections.
AUTHORIZATION AND RELEASE OF LIABILITY                                                                                                                                                                                                                                                                 I, the parent or guardian of the participant-named child, authorize the participation of my child in the UB All Star athletic program of University Boulevard Nazarene Church. My child will participate in the sport denoted on this brochure. I understand that this program is a nonprofit Christian sports ministry program for youth and that my child’s           participation Is voluntary and not essential to completion of requirements of any program, school or government agency. I understand that the program is conducted by the Church and its volunteers and staff, including parents of other participating children. I also understand that the Church is solely responsible for all aspects of the program, including     selection and supervision of all persons conducting the program. I further understand and agree that my child’s participation in athletic and other activities of the program      necessarily involves the risk of injury and even death from various causes, including but not limited to accidents, fall, strenuous and prolonged physical activity, dehydration, illness, collision or dispute with other participants, weather related injuries, playing areas and equipment defects, and negligence of coaches and referees. On behalf of my child, me and my family, I assume these risks. In consideration of the privilege of my child’s participation in the program, and on behalf of my child and me as parent/guardian, I hereby release discharge, hold   harmless and indemnify, and covenant not to sue the Church, and all of the church’s directors, officers, elders, trustees, deacons, employees, volunteers, insurers, agents and representatives and all other persons associated the program (including with limitation any other participating church sponsors, parents, vendors, coaches and other game and event workers, officials, drivers and organizers) as to any and all claims of my child, me and other family members for person injuries suffered by my child, property damage,  medical expenses, and economic loss arising directly or indirectly out of my child’s participation in the program, and any first aid, medical care or treatment provided to my child in the event my child is injured or becomes ill while participating in program activities, and excepting claims that may not be released under applicable law. This Release of Liability shall be as broadly construed as allowed by law to include all claims and rights that the child, that I as parent/guardian, and that other family members may have. I am a legally responsible parent or guardian of my child. If any provision of this Release of Liability is deemed invalid, the remaining provisions shall remain in full force and effect. This Release of Liability shall be binding on me, my family, heirs, next of kin, legal representatives, beneficiaries, successors and assigns. I hereby authorize the Church to use, reproduce, distribute, display and to license other to use, reproduce, distribute, and display, my child’s image, and photograph as well as any video, digital or audio recording or reproduction, in connection with external and internal communications of the Church for the sole purpose of advancing the sports programs.                                                                                                                                                               MEDICAL CONDITIONS: I understand that participation in this program may involve strenuous and prolonged physical activity. I agree that my child is healthy and able to        participate in the program activities. I understand that the Church or its representatives may request heal information concerning my child and /or ask my child to undergo a  medical exam. If the Church determines that my child does have a physical or mental condition that may affect his/her ability to safely and appropriately participate in program activities, the Church may determine that my child cannot be permitted to participate. I understand and agree that, while the Church desires that all children will be able to    participate, such decisions may have to be made out of concern for the best interest of my child and other participants.                                                                                                                                                                                                                      CONSENT TO MEDICAL TREATMENT: In the event my child is injured or becomes ill in program activities, and if, I, the parent or guardian of the named child, am not present to make medical decisions, I hereby authorize the Church, its staff, volunteers, including volunteer parent participants, coaches, assistant coaches, and referees, supervisors and drivers, to arrange for and consent on my behalf to emergency medical and dental care and treatment, including tests and radiological exams, and surgery, and hospital care and treatment, and to consent to medications for pain and other conditions as prescribed by medical personnel attending my child. I am responsible for payment of any medical   charges or expenses not covered by my insurance or the insurance applicable to my child (if any). My signature below indicates that all information provided in this form is true   and accurate, and that I fully agree to all statements made on the form, including, but not limited to the Authorization and Release of Liability, Medical Conditions,  and Consent    to Medical Treatment. Each responsible parent/guardian should sign.

Parent/Guardian First Name *

Parent/Guardian Last Name *

Parent/Guardian First Name

Parent/Guardian Last Name