2023-2024 Program Player Registration

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Player Information

Player/Child Name* Address* Birthdate*

School* Current Grade* Report Card/Progress Report Uniform Number Uniform Size

Parent's Information

Primary Parent Name*

Primary Parent's Address (if different from child)

Primary Parent's Telephone*

Primary Parent's Email*

Secondary Parent Name

Secondary Parent's Address (if different from child)

Secondary Parent's Telephone

Secondary Parent's Email

I hereby agree that the photographs, video recordings, newspaper, television or radio interviews of myself or my child may be used in the promotion of, and for the purposes of Dream Prepare Compete without any compensation to me whatsoever.*

Medical Waiver

Emergency Contact Name*

Emergency Contact #*

Does the participant have any medical conditions, health concern, allergies or special needs that we should be aware of?* Yes No

If yes, describe here:

Do you have medical insurance?* Yes No

In Consideration of my child/ward being allowed to Name of Minor Child/Ward participate in any way in Dream Prepare Compete related events and activities, the undersigned acknowledges, appreciates, and agrees that: The risks of injury and illness (ex: communicable diseases such as MRSA, influenza, and COVID-19) to my child from the activities involved in these programs are significant, including the potential for permanent disability and death, and while particular rules, equipment, and personal discipline may reduce these risks, the risks of serious injury and illness do exist; and, 1. FOR MYSELF, SPOUSE, AND CHILD, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES or others, and assume full responsibility for my child’s participation; and, 2. I willingly agree to comply with the program’s stated and customary terms and conditions for participation. If I observe any unusual significant concern in my child’s readiness for participation and/or in the program itself, I will remove my child from the participation and bring such attention of the nearest official immediately; and, 3. I myself, my spouse, my child, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Dream Prepare Compete; 4. its directors, officers, officials, agents, employees, volunteers, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“Releasees”), WITH RESPECT TO ANY AND ALL INJURY, ILLNESS, DISABILITY, DEATH, or loss or damage to person or property incident to my child’s involvement or participation in these programs, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law. 5. I, for myself, my spouse, my child, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY INDEMNIFY AND HOLD HARMLESS all the above Releasees from any and all liabilities incident to my involvement or participation in these programs, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent permitted by law. 6. I, the parent/guardian, assert that I have explained to my child/ward: the risks of the activity, his/her responsibilities for adhering to the rules and regulations, and that my child/ward understands this agreement. I, FOR MYSELF, MY SPOUSE, AND CHILD/WARD, HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT WE HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.*

Electronic signature: I/We have read, understand and agree to comply with the Waiver as outlined above.*

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26

Jul

2023-2024 Player Program Registration

Date: 26 July 2024, 00:00

Required (yearly) Registration

26

Jul

8U Summer League 2024

East Lake YMCA

Date: 26 July 2024, 15:35

8U Summer League East Lake YMCA

26

Jul

10U Summer League 2024

Date: 26 July 2024, 15:38

10U Summer League East Lake YMCA

26

Jul

12U Summer League 2024

Date: 26 July 2024, 15:39

12U Summer League East Lake YMCA

26

Jul

14U Summer League 2024

Date: 26 July 2024, 15:40

14U Summer League East Lake YMCA

26

Jul

16U Summer League 2024

Date: 26 July 2024, 15:41

16U Summer League East Lake YMCA

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