Rally Sport Registration-ZeroZero

Rally Sport 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 (2024/2025 School Year)*
Which Rally Sport Events Are You Interested In?*

BasketballFootballVolleyballGolfSoccerBaseball/Softball
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*
Home Phone
Work Phone
Where would you like to be reached while your child is at Rally Sport?*

Cell PhoneHome PhoneWork Phone
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
Home Phone
Work Phone
Where would parent/guardian 2 like to be reached while your child is at Rally Sport?

Cell PhoneHome PhoneWork Phone
Home Address Same as Parent/Guardian 1?

Yes
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*
Home Phone Number
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*
Home Phone Number
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).*

YesNo
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)*

YesNo
Sign Document*
Date Signed*

MonthDayYear
Today's Date
Should be Empty: