Player's Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Uniform Size *

Small

Medium

Large

X-Large

Parent or Guardian's Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Phone

(###)

###

####

Parent or Guardian's Cell Phone *

(###)

###

####

Are you interested in volunteering in any of the following?

Stats

Operating the scoreboard

Other serices

Emergency Contact *

First Name

Last Name

Emergency Contact's Phone *

(###)

###

####

Consent to Provide Medical Care *

In the event of illness or accident, I give my permission for emergency treatment by qualified medical personnel for my child, and I authorize the person in charge to accompany my child to the emergency facility. I give consent for the facility to secure any and all necessary emergency medical care for my child.

I Agree

I DO NOT Agree

Terms and Conditions *

Although the safety of all sport activities is the primary concern, indoor sport activities at Youth Sport Center's facilities may cause injuries and/or death. I expressly assume the risk of injury, death, and/or illness arising from any cause, and agree to waive the right to pursue any claim against the Youth Sport Center and the persons in charge.

I Agree