Rally Sport Registration-ZeroZero

ZeroZero Foundation Registration Form

Please fill out this form if you are interested in your child joining ZeroZero Foundation! Our Mission is to leverage the diverse opportunity of sports to enrich the lives of underserved youth. One child, one family, one community at a time!
Participant's Information
Participant Name

First NameLast Name
Nickname
Gender
Date of Birth

MonthDayYear
Reminder: Rally Sport is for kids aged 6-12.
School Participant Attends:
Current Grade Level (2025/2026 School Year)
Which Rally Sport Events Are You Interested In?
T-Shirt Size
Size is not guaranteed, but we will do our best to fulfill your request
Please provide any additional information that you think is important or may affect the participant's ability to fully participate in the program.

Parent's/Guardian's Information

Only the parent/guardian or emergency contact will be able to pick up the participant. You will be required to show valid photo identification in order to pick up the participant.
Parent/Guardian #1
Parent/Guardian #1

First NameLast Name
Relationship to Child
E-mail
Cell Phone
Format: (000) 000-0000.
Home Phone
Format: (000) 000-0000.
Work Phone
Format: (000) 000-0000.
Where would you like to be reached while your child is at Rally Sport?
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian #2
Parent/Guardian #2

First NameLast Name
Relationship to Child
E-mail
Cell Phone
Format: (000) 000-0000.
Home Phone
Format: (000) 000-0000.
Work Phone
Format: (000) 000-0000.
Where would parent/guardian 2 like to be reached while your child is at Rally Sport?
Home Address Same as Parent/Guardian 1?
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Emergency Contacts/Authorized Pickup

Parent/guardian cannot be listed as emergency contacts. List the name of at least one person who can be contacted in the event of an emergency or illness if you cannot be reached. Any person listed should be able to assist in contacting you. At least one person listed must be able to take responsibility for the child in case the parent/guardian cannot be reached. Only the parent/guardian or emergency contact will be able to pick up the participant. You will be required to show valid photo identification in order to pick up the participant.
Emergency Contact #1
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number
Format: (000) 000-0000.
Home Phone Number
Format: (000) 000-0000.
Relationship to Child
Emergency Contact #2
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number
Format: (000) 000-0000.
Home Phone Number
Format: (000) 000-0000.
Relationship to Child

Statement of Understanding
I, the undersigned, hereby authorize Zero Zero Foundation to photograph, take motion pictures, take video footage, and/or make electronic sound recordings of the registered camper (herein referred to as photographic or electronic reproductions).
I authorize the use of any such photographic or electronic reproductions for any purpose, including, but not limited to educational and other public media as may be deemed appropriate by Zero Zero Foundation. (I understand that the camper may be identifiable from such photographic or electronic reproduction)
Sign Document
Date Signed

MonthDayYear
Today's Date
Should be Empty: