Registration Form – Youth – AGBU MTL SPORTS

Youth Basketball Registration Form

Child's Name

First

Last

Date of Birth

Which school grade is your child in ?

Gender

Home address

Primary contact person (one of the parents)

First

Last

Cell number

E-mail

Second contact person

Parent's cell phone number (copy)

Parent's email (copy)

Does your child have any allergies or medical issues that we should know of?

Waiver and Liability *

I understand and accept the terms stated here

By checking this box I attest that I understand that participation in the sports program involves risk, and I agree to assume those risks. I hereby release and hold harmless AGBU, its committees and the volunteers involved in the program from any liability arising from my personal or my child’s participation in this program