Registration Form

Affiliated Organization

Fourth Annual Basketball Tournament

  • Time: Saturday Novermber 20, 2010 @ 8:00 AM
  • Place: Smith College Ainsworth and Scott Gym
  • Price: $200 per team (postmarked by November 6th)
  • Mail Checks & Payable To:
    • Lillian Chi
      Box 6483 1 Chapin Way
      Northampton, MA 01063
  • Registration must be completed by November 13, 2010
  • Checks must be postmarked by November 13, 2010
Organization Name:
President Name:
School:
Phone Number:
E-Mail:

Team Information

Roster Name Graduation Year School Phone Number E-Mail
1
2
2
3
4
5
6
7
8

Additional Comments or Questions


How did you find out about the basketball tournament?
Campus KSA/ASA
E-Mail
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Other

Disclaimer

By clicking submit you (and your teammates) certify that:

  1. The above information is correct
  2. That in consideration and as a condition of the above identified registrant's participation in the Basketball Tournament, agree to
    indemnify, defend and hold harmless the Smith KASS, its executive board and event staff from and against any and all liability
    from injury which may be suffered as a result of or in any connection with or arising out of the registrant's participation in the
    above tournament
  3. That the responsibility for carrying appropriate medical plans, including hospitalization lies with the participants
  4. Agree to abide by all stipulations in the rules and regulations

If you have any additional inquiries, do not hesitate to contact us at kass@smith.edu
I (We) have read and agree to the rules outlined in the Disclaimer.

Rules & Regulations   Registration Form