Restore Games 2024 Participants Registration

Restore Games East 2024

Participants Registration
Parent/Guardian Information

Please fill out this form in its entirety.
Which parent(s)/guardian will be attending?*

FatherMotherSiblingRelative
Name of the Father:*

First NameLast Name
Father's Phone Number:*
Please enter a valid phone number.
Father's Email:*
example@example.com
Father's Home Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Father's Zip Code*
Name of the Mother:*

First NameLast Name
Mother's Phone Number:*
Please enter a valid phone number.
Mother's Email:*
example@example.com
Mother's Home Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mother's Zip Code*
Name of the Sibling:*

First NameLast Name
Sibling's Phone Number:*
Please enter a valid phone number.
Sibling's Email:*
example@example.com
Sibling's Home Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Sibling's Zip Code*
Gender of the Sibling*
Name of the Relative:*

First NameLast Name
Relative's Phone Number:*
Please enter a valid phone number.
Relative's Email:*
example@example.com
Relative's Home Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Relative's Zip Code*
Gender of the Relative*
Are you an AAU Player?*
If so, what team and sport?*
IMPORTANT NOTE: Parent/guardian must stay with their children at all times.
Are you from the Housing Authority of Birmingham District Summer Camp?*
How many children would you like to register?*

Waiver and Release of Liability

In consideration for being permitted to participate in the Restore Games 2024 (the "Event"), organized by Jefferson County Family Resource Center, I hereby acknowledge and agree to the following:
1. I understand that participating in the Event involves inherent risks, including but not limited to physical injury, illness, and property damage, which may result from my own actions or the actions of others.
2. I hereby release, waive, discharge, and covenant not to sue Jefferson County Family Resource Center, its officers, employees, volunteers, agents, and representatives (collectively, the "Released Parties") from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me, or to any property belonging to me, whether caused by the negligence of the Released Parties or otherwise, while participating in the Event.
3. I agree to indemnify, defend, and hold harmless the Released Parties from and against any loss, liability, damage, or cost, including reasonable attorney fees, incurred by any of the Released Parties arising out of or related to my participation in the Event or my breach of this Waiver and Release of Liability.
4. I authorize the Released Parties to secure medical treatment or transportation for me in the event of any injury or medical emergency during my participation in the Event.
5. I have read this Waiver and Release of Liability, fully understand its terms, and understand that I am giving up substantial rights, including my right to sue.
6. I acknowledge that I am voluntarily participating in the Event, and I agree to be bound by its terms. This Waiver and Release of Liability shall be governed by and construed in accordance with the laws of Birmingham, AL.
7. If any provision of this Waiver and Release of Liability is found to be unenforceable or invalid, the remaining provisions shall be enforceable to the fullest extent permitted by law.
8. I, the undersigned, acknowledge and agree that I will not leave my child unattended at any time during the RESTORE Games Event. I understand that it is my responsibility to supervise my child and ensure their safety and well-being throughout the event.
9. Photo/Media Release: I, the undersigned, grant permission to the Jefferson County Family Resource Center and its partners to use photographs, video recordings, and any other media taken during the RESTORE Games Event for promotional, educational, or other purposes without compensation to me or my child.
I HAVE READ THIS WAIVER AND RELEASE OF LIABILITY, FULLY UNDERSTAND ITS TERMS, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
Date*

MonthDayYear
Date
Signature*

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Should be Empty:

Restore Games East 2024

Parent/Guardian Information

Child's Information

Second Child Information

Third Child Information

Fourth Child Information

Fifth Child Information

Sixth Child Information

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