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× DOJO Membership Registration
Name:

Cecil Williams

Address:

5484 Chambray Ct
Highlands Ranch, Colorado 80130
United States
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Phone:

(303) 859-8380

Email:

cewilliams2011@me.com

Username:

cewilliams2011@me.com

Player Name:

JJ Williams

Date of birth:

10/22/2004

School Currently Attending:

ThunderRidge HS

T-shirt size:

AL

Short size:

AL

Gender:

Male

Player grade:

10th

Player level:

Advanced

Player experience:

Competitive Leagues

Position:

Guard/Shooting

Basketball Tao Dojo General Participation and COVID -19 Liability Release:
  • I agree and affirm to the following today and each I come into Basketball Tao Dojo for basketball services, until further notice (check next to each statement).
  • I understand that the above symptoms and affirm that I, as well as all of those that I am living with me do not currently have, nor experienced the symptoms listed above within the last 14 days. In addition, I do have a runny or nose or any open wounds.
  • I affirm that I, as well as all household members, have not been diagnosed with COVID-19, within the last 30 days.
  • I affirm that if I develop any of the above symptoms and/or am diagnosed positive for COVID-19, within 14 days of my last visit to Basketball Tao Dojo that I will notify Brian Howard immediately via email at Info@basketballtao.com
  • I agree to follow the sanitizing instructions upon entry and exit.
  • I agree to wear a mask while inside the facility
Signature:

1 x $65.00 / year
$65.00 / year 1 $65.00 / year
Cart totals

Cart totals

Subtotal $65.00
Total $65.00
Recurring totals
Subtotal $65.00 / year
Recurring total $65.00 / year
First renewal: October 19, 2021

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