Miniletics Academy Registration Form

Miniletics Academy Registration

Welcome to our children's sports program! Please fill out this form to register your child for the sports program.
Child's Full Name*

First NameLast Name
Parent/Guardian's Full Name*

First NameLast Name
Parent/ Guardian's Email Address (Please make sure the email is typed correctly)*
example@example.com
Phone Number*
Please enter a valid phone number.
Child's Date of Birth*

MonthDayYear
Date
There is an annual registration fee of $40, which includes a program jersey. This fee is required each school year to help support program resources, equipment, and administrative costs.
Type Your Child’s Jersey Size:
Is this your first time registering with Miniletics Academy?*

YesNo
Medical Conditions / Known Allergies
Emergency Contact Information
Emergency Contact Name*
Emergency Contact Phone Number*
Please enter a valid phone number.
Additional Information
Any additional information you'd like to provide?
Student Media Release: Choose one option*

I, parent or guardian of named child, Grant permission to Miniletics Academy LLC to use photographs and/or videos taken of my child for use ONLY in promotional and educational materials such as brochures, newsletters, Miniletics website gallery and Miniletics Academy social media pages. Yo, padre o encargado de niño(s) nombrado, le doy permiso a Miniletics Academy LLC para usar fotografías y/o videos tomados de mi hijo para su uso ÚNICAMENTE en materiales promocionales y educativos como folletos, boletines, galería del sitio web de Miniletics y páginas de redes sociales de Miniletics Academy.I, parent or guardian of named child, I DO NOT Grant permission to Miniletics Academy LLC to use photographs and/or videos taken of my child for use ONLY in promotional and educational materials such as brochures, newsletters, Miniletics website gallery and Miniletics Academy social media pages. Yo, padre o encargado de niño(s) nombrado, NO doy permiso a Miniletics Academy LLC para usar fotografías y/o videos tomados de mi hijo para su uso ÚNICAMENTE en materiales promocionales y educativos como folletos, boletines, galería del sitio web de Miniletics y redes sociales de Miniletics Academy. páginas de medios.
Waiver Terms & Conditions:
By providing my Signature I have read and agree to all Waiver Terms & Conditions & Student Media Release. Signature Required *

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Miniletics Academy Registration

Emergency Contact Information

Additional Information

Waiver Terms & Conditions: