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Athlete First & Last Name
Guardian First & Last Name
Submit
Athlete Date of Birth (D.O.B.)
Athlete Phone
Guardian Email
Address | City | State | Zip Code
Guardian Phone
Clutchest Position
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Most Challenging Position
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Height
Weight
I hereby declare that the information provided is true and correct. I also understand that any willful dishonesty may disqualify my child from participating in the Crowned Clutch 3v3 basketball tournament.
My child and I understand that we must wear a mask during all non-competitive moments.
Have you, your child or anyone in your household had any of the following symptoms in the last 21 days: sore throat, cough, chills, body aches for unknown reasons, shortness of breath for unknown reasons, loss of smell, loss of taste, fever at or greater than 100 degrees Fahrenheit?
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To the best of your knowledge have you or your child been in close proximity to any individual who tested positive for COVID-19?
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Have you, your child or anyone in your household been tested for COVID-19?
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Have you, your child or anyone in your household visited or received treatment in a hospital, nursing home, long-term care, or other health care facility in the past 30 days?
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Have you, your child or anyone in your household traveled in the U.S. in the past 21 days?
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Jersey Size
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Short Size
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Please Select Division
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Grade Level
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Name of High School
Date of Submission
ARE YOU HAVING TROUBLE?
No worries! Please email us at
deliverwell@crownedclutch.org
or give us a call at 844-748-0414
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