All Star Basketball Games

       in Harrisburg, PA

 

The dates are
March 27 at Susquehanna Twp. H. S.

Mid Penn vs. Keystone Boys
Mid Penn vs. Keystone Girls
Pennsylvania vs New Jersey

April 4at Steelton-Highspire H. S.

North vs. South Girls
North vs. South Boys
Pennsylvania vs. Maryland Girls
Pennsylvania vs. Maryland Boys

 

 

Nominate players, find a ballot HERE

   Past all star results information  HERE
Pennsylvania/Maryland Senior All-Star series history found HERE

 

Do you want to be featured on a page in the All Star Program?  All-Star Program Page Information

 

Player Participation Form

Name _______________________________

Address ______________________  Phone _________

City/State/ZIP ____________________________

School/State______________________________
 

 

 

 

(Players cannot participate unless they have medical insurance).

 

ALL-STAR MEDICAL RELEASE FORM
All players who participate in the All-Star Game(s) must have medical coverage.  In order to be eligible to play you must either
1-Fill in your insurance information below to demonstrate you do have coverage,

Or

2-If you don’t have coverage, then send a check for $10.00 to pay for a one day policy to provide accident insurance and fill in the “One Day Policy” Form.

 

1-Fill in this form if you do have coverage:

Parent Consent and Medical Information
(Players cannot participate unless this section has been completed and signed by the parent or guardian). I understand that the All-Star Game and the host school do not carry medical or accident insurance for the participants, and I here by certify that my child is covered by personal insurance or is included in a policy which I have in place. I authorize routine medical care for my child by the All-Star trainer. I further authorize any treatment considered routine to be referred to a local physician or to an emergency room at my expense. I further authorize and provide my consent and permission for my child to participate in this event.

Players Name __________________________________  School ____________________________

Insurance Company ____________________ Policy _____________ Group # ________

Name of Policy Holder _____________________________ Home Phone __________

Signature of parent/guardian _________________________ Cell phone _____________

send this form to:
Bill Gaffey
417 Bolton Drive
Harrisburg, PA
17112



2-If you do not have coverage, fill in this form and include a check for $10.00 payable to Keckler-Heitefuss Insurance:


                                     "One Day Policy" Form


Name ___________________________________ City   _____________________

Address _________________________________    State ______  Zip  _________

 

Cell phone _____________________    Home phone _____________________

 

Signature of parent/guardian _________________________

Make your check payable to: Keckler-Heitefuss Insurance:
and send everything to: All-Star Coverage, c/o Bill Gaffey
                              417 Bolton Drive, Harrisburg, PA 17112
                                                                                                        

(Players cannot participate unless they have medical insurance).