REGISTER! - New Level Sports Ministries

Date

Youth Name*

First Last

Gender

Male
Female

School

Grade

Current GPA

Age

Birth Date

Home Address*

Street Address Address Line 2 City State ZIP Code

Phone

Email

I want to enroll my child in the following program(s):

Male Head of Household

First Last

Phone

Female Head of Household

First Last

Phone

Other Emergency Contact

First Last

Phone

Emergency medical conditions of youth...

Please contact me because I am interested in volunteering in the following areas(s):

Concessions
After School Meal Preparation/Service
Coach/Assistant Coach
After School Enrichment/Tutoring
Personal Growth Assistant
Other (please list)

Other

I hereby give my consent for the New Level Sports Ministries to use my child’s photograph and likeness to be used in its publications, including its website. I release them from any expectation of confidentiality for the undersigned minor child and attest that I am the parent or legal guardian of the child listed below.

My child has permission to participate in the new level sports athletic programs. I hereby release and waive any and all claims against new level sports and any agents, representatives, officers, board of directors, coaches, and other personnel of the same, from any responsibility of liability or liability for any injury, loss or damage which may hereafter be suffered or sustained by my child arising out of their playing or participating in this program. This includes while competing, traveling to or from any game, practice or activity sponsored by new level sports or while a spectator at any game or practice.

I authorize the head coach of my child’s team, new level sports staff, or emergency personnel to seek and/or provide medical attention for my child if I cannot be contacted.

Signature

First Last

Date

Downloadable Form

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