Linda and Bill Gantz Club Ian Dabney Basketball Tournament – Registration Form

This is the first annual Linda and Bill Gantz Basketball Tournament in Memory of Ian Dabney.

Name of Participant*
First Last
Participant Date of Birth*
MM slash DD slash YYYY
Participant Age*
Participant T-shirt Size*
Participant Skill Level*
Email to be reached for further information:
Parent or Guardian Consent
I have explained the rules to my child and agree that BGCC will not be responsible for any accident to the child while on BGCC premises or while engaged in any activities away from BGCC. I give my consent for photographs, video, or other media in which my child may appear, to be used in any way BGCC chooses, and for my child to participate in media opportunities overseen by BGCC.
Parent or Guardian Consent*
I agree to Boys & Girls Clubs of Chicago's consent policy.
Parent or Guardian Name
First Last
Parent or Guardian Phone Number
Emergency Contact Name (must be different than the name above)
First Last
Emergency Contact Phone Number

Parent or Guardian Consent