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Clatyon Academy Registration
For all Clayton Communities
Player Name
First Name
Middle Name
Last Name
Date Today
-
Month
-
Day
Year
Date
Date of Birth
-
Month
-
Day
Year
Date
Age
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of School
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Team Application Information
6-8 yrs of age.
9-11 yrs od age.
Choose your sport
*
Baseball
Basketball
Esports
Football
Soccer
Softball
Volleyball
Position
Please Select
Quarterback
Running Back
Wide Receiver
Kicker
O line
D line
Linebacker
Corner back
SG
PG
SF
PF
C
1ST BASE
2ND BASE
SHORT STOP
3RD BASE
PITCHER
CATCHER
OUTFIELDERS
Volleyball
Soccer
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Emergency Contact Information
Name of Emergency Contact
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Relation to Athlete
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Parental/Guardian Consent
Conforme
I hereby declare that in my full knowledge and capacity, I give my express and full permission to let my child be treated by qualified medical physician in any circumstance that such attendance be so required to perform all or any immediate medical check-up or treatment
Name of Doctor
First Name
Last Name
Clinic / Hospital
Waiver
I am fully aware that this sport activity may cause accidental injury to athletes. I likewise assume any and all possible risk that may cause injury, illness, or death arising to such activity. I hereby declare that I waive my right to pursue any and all claims against the Commission and the Organizing Committee of this event should in any case that the accident, injury, illness or death occurs in the course of any activity held by them.
Signature of Parent / Guardian
Name
First Name
Last Name
Date Signed
-
Month
-
Day
Year
Date
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