Elite Boys and Girls Club Registration Form

Texas Typhoons- Texas Kings 7 v 7 - Registration Form (age 10and older)

Athlete Information

Player Name

First NameLast Name

YesNo

Guardian / Parent Name*

First NameLast Name

Guardian / Parent Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

City

Postal / Zip Code

Home Phone*

Area CodePhone Number

Cell Phone

Area CodePhone Number

E-mail*

Football skill level*

	1	2	3	4	5

1 is Begginer, 5 is Advanced

Match RefereeOperate Scoreboard

Important Notes · Dress appropriately. · No food or drink in the gym. · Keep the gym clean. · The league organizers reserve the right to form the teams to ensure the talents of all teams are balanced.

Emergency Contact & Health Insurance Information

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Area CodePhone Number

YesNo

Insurance Carrier

Name of Policy Holder

Subscriber ID/Group Number

Card Number / Card Date

YesNo

Please describe*

Parental Permission For Emergency Treatment In the event of illness or accident, I give my permission for emergency treatment by qualified medical personnel for my child, and I authorize the person in charge to take my child to: I give consent for the facility to secure any and all necessary emergency medical care for my child.

Name of Physician / Emergency Medical Care Facility

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Area CodePhone Number

Type a question

Signature

Release of Liability Although the safety of all sport activities is the primary concern, indoor sport activities at Youth Sport Center's facilities may cause injuries and/or death. I expressly assume the risk of injury, death, and/or illness arising from any cause, and agree to waive the right to pursue any claim against the Youth Sport Center and the persons in charge.

YesNo

Confirmation E-mail*

Signature*

After completing this form, please click Submit Form. You will receive a confirmation email. If you do not receive the email within a few minutes, please check your spam; otherwise, please contact us at info@eliteboysandgirlsclub.org

We recognize the need to ensure the welfare and safety of all young people
taking part in any activity associated with our organization.
In accordance with our child protection policy we will not permit photographs,
video or other images of young people to be taken without the consent of the
parents/carers and children. As your child will be taking part in the event
specified above, we would like to ask for your consent to take
photographs/videos of the event or activity that may contain images of your
child. It is likely that these images may be used as
• a record of the activity or the event
• in a written evaluation of the event that will be viewed by the public
• publicity material for further activities or events on
leaflets/websites/magazines
• illustrations of the activities or events in published articles
• future grant applications

We will take all steps to ensure these images are used solely for the purposes
they are intended. If you become aware that these images are being used
inappropriately you should inform us immediately.

I consent to having my child photographed or recorded for this event contd.

Signature

Child's Name:blanks
Parent or Legal Guardian's Name: blank
Parent or Legal Guardian's Signature and Date: Signature Date

RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AND PARENTAL CONSENT AGREEMENT (“AGREEMENT”)

Below section must be completed by Parent/Guardian for any participant under the age of 18.

IN CONSIDERATION of being permitted to participate in any way in any Elite Boys and Girls Club and Texas Typhoons activity (“Activity”) at any time during the current calendar year I, for myself, my personal representatives, assigns, heirs, and next of kin:

1. ACKNOWLEDGE, agree and represent that I understand the nature of Elite Boys and Girls Club and Texas Typhoons Activities and that I am qualified, in good health, and in proper physical condition to participate in such Activity. I further agree and warrant that if at any time I believe the conditions to be unsafe, I will immediately discontinue further participation in the Activity.

2. FULLY UNDERSTAND that: (a) Elite Boys and Girls Club and Texas Typhoons ACTIVITIES INVOLVE RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS, AND DEATH (“Risks”); (b) these Risks and dangers may be caused by my own actions or inactions, the actions or inactions of others participating in the Activity, the condition in which the Activity takes place, or THE NEGLIGENCE OF THE “RELEASES” NAMED BELOW; (c) there may be OTHER RISKS AND SOCIAL AND ECONOMIC LOSSES either not known to me or not readily foreseeable at this time; and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I incur as a result of my participation or that of the minor in the Activity.

3. HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE Elite Boys and Girls Club and Texas Typhoons, it’s administrators, directors, agents, officers, members, volunteers, team members, and employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessors of premises on which the Activity takes place, (each considered one of the RELEASES herein) FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON MY ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE RELEASES OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS; AND I FURTHER AGREE that if, despite this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT I, or

anyone on my behalf, makes a claim against any of the Releases, I WILL IDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASES from any litigation expenses, attorney fees, loss, liability, damage, or cost which may be incurred as the result of such claim.

I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND HAVE SIGNED IT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID, THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.

Signature

Parental Photo Consent Form for Children/Minors

Release And Health Waiver