Raptors Elite Registration

Raptors Elite Registration Form

Child's First Name

Last Name

Current Grade

Date of Birth

Age

Gender

Parent's Name

Parent's E-mail Address

Street Address

City

State

Zip Code

Home Phone

Cell Phone

Work Phone

Sports Registration

Jersey Size

Team Grade/Age

Medical Condition(s)/Allergies

I am willing to volunteer as a(n)

Name of Person Volunteering

In Case of Emergency Name of local friend or relative (Not living at same address)

Relationship to child

Home/Work Phone

Cell Phone

By my/our submission of the registration form, and payment of the registration fee, I/we (the parent(s)/guardian of the player named above) hereby give my/our approval for him/her to participate in any and all M.Y.A. SPORTS activities. I/We also waive, release, absolve, indemnify, and hold harmless M.Y.A. SPORTS, Seminole County School Board, their officers, directors, sponsors, drivers, employees, coaches, and volunteers for any claim arising out of an injury to the player named above. I/we acknowledge that in all sports there are certain risks of physical injuries, and all players participate at their own risk. Further, I/we, and the player(s) named above agree to abide by all rules, regulations, and guidelines established by M.Y.A. SPORTS. A $35 fee will be assessed for returned checks for insufficient funds. I give permission for M.Y.A. SPORTS to photograph, video tape and/or film child while participating in any M.Y.A. SPORTS activities to be used by M.Y.A. SPORTS, for educational and promotional purposes. Parent/Guardian Signature

Date

Please initial here if you would like your child to opt out of all photography done by M.Y.A. SPORTS

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