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Ss Cyril & Methodius Church CYO Basketball
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Travel Registration Form 2024
PLAYER INFORMATION
*
Player's First Name:
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Player's Last Name:
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Street:
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City:
State:
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Zip Code:
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Birthdate:
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
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2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
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Gender:
Male
Female
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Grade as of Sept/24:
Select one below
3rd $215
4th $215
5th $215
6th $215
7th $215
8th $215
9th $215
10th $215
11th $215
12th $215
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Uniform Size:
Child Small (6-8)
Child Medium (10-12)
Child Large (14-16)
Adult Small
Adult Medium
Adult Large
Adult XL
Adult XXL
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School as of Sept. 2024:
PARENT/GUARDIAN
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Full Name:
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EMail:
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Home Phone:
*
Cell Phone:
MEDICAL/EMERGENCY CONTACT INFORMATION
Emergency Contact:
Phone:
Relationship to Player:
WAIVER INFORMATION
RELEASE OF LIABILITY FOR MINOR PARTICIPANTS
READ BEFORE SUBMITTING FORM
IN CONSIDERATION OF allowing my child/ward, being allowed to participate in any way in the Ss Cyril CYO Basketball related events and activities, the undersigned acknowledges, appreciates, and agrees that:
The risk of injury to my child from the activities involved in these programs is significant, including the potential for permanent disability and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and,
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,
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,
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 Ss Cyril & Methodius CYO; 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, 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.
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.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING OR CLICKING THE SUBMIT FORM BUTTON, AND AGREE FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
I understand the seriousness of the risks involved in participating in this program, my personal responsibilities for adhering to rules and regulation, and accept them as a participant, by clicking the SUBMIT FORM button, I agree to this waiver.
I/we agree with the above
*
* indicates required fields