ELEVATE ALLSTAR REGISTRATION FORM

Elevate Allstar welcomes your child to our youth sports program under Elevate Her Youth Foundation. Elevate He Youth Foundation is committed to empowering girls aged 5-17 through mentorship, college readiness, and finan literacy while leveraging the transformative power of sports. Our mission is to nurture confident, well rounded women who are equipped with the skills and support needed to succeed in all facets of life. As a condition of your child's participation in this program, you must complete and sign the attached form and it to Elevate Allstars. If you do not want to authorize Elevate Allstars and/or Elevate Her Youth Foundation to se medical treatment for your child in the event of an accident and you cannot be contacted, then cross out and init medical authorization paragraph. Be sure, nonetheless, to complete the "Emergency and Medical information" section. Thank you.

This form has four sections (1) an assumption of risk and release; (2) paragraph of instruction; (3) medical authorization; and (4) a participant information form. The first section tells you about risks of injury that may arise from participating in a sport or activity of Elevate Her Youth Foundation in order to aid you in making an informed decision as to whether or not your child should participate in Elevate Allstars activity and requires you to assume its risks. The second section emphasizes obedience to safety rules. The third section gives the program authorization to provide medical care in case an accident should happen and you cannot be contacted. The fourth section provides theprogram t important information about your child. As a parent or guardian, you should ask coaches, physicians, and other knowledgeable persons about any concerns that you might have about your child's participation or safety. The decision for your child to participate is yours.

Injuries to participants in the Youth Sports Program may occur from risks inherent in the sports or activity; from placing stress on the body that has not been prepared for; from accidents in learning or practicing playing techniques; from failing to follow game, training, safety or other team rules; from the use of transportation to and from games and other events; and from administration of first aid. Injury can include direct physical, and possibly crippling, injury to one's body, and emotional injury experienced as a result of inflicting injury to another or witnessing it. The severity of injury can range from minor cuts, scrapes, or muscle strain to catastrophic injury, such as paralysis or death. In consideration of Elevate Allstars and Elevate Her Foundation permitting my child or ward to participate in its Youth Sports program ,I hereby agree on behalf of my child that he or she will assume the risk of injury or death from participating as outlined above.I release Elevate Allstars, Elevate Her Foundation, the city, and/or volunteers from any liability resulting from my child's particiapting in the sport or activity.

I have told my child to obey all directions of the instructors and personnel in charge of the sport or activity and their assistants; to comply with all safety instructions; and to refrain from horseplay and other unsafe practices.

In the case of an accident or illness, I authorize the City to provide medical treatment for my child if I cannot be contacted immediately andI consent to the administration of any and all medical procedures deemed necessary by the attending authorities. | understand that the City, its staff, and volunteers assume no financial obligations or liability for the immediate medical treatment that they provide to or for my child.

IV. EMERGENCY AND MEDICAL INFORMATION

Person to contact in an emergency:

Alternate person to contact in an emergency:

My child may be photographed (stills or video) for the Elevate Allstars and Elevate Her Foundation publications. Initial Here

I/We have agreed to assume the risks of participation and the release, given the instruction, authorized immediate medical attention if I/we cannot be contacted, and completed the emergency and medical information.