Fall 2024 Signups

Player's Information

Name

First NameLast Name

Name

First NameLast Name

Birth Date

MonthDayYear

Birth Date

MonthDayYear

Gender

MaleFemaleOther

Gender

MaleFemaleOther

Address

Street Address

Street Address Line 2

CityState

Postal CodeCountry

School

Grade

Select Group

Shirt Size

Choose three jersey number choices

Parent/Guardian Information

Name

First NameLast Name

Mobile Number

Area CodePhone Number

E-mail

Emergency Information

Emergency Contact's Name

First NameLast Name

Relationship

Phone Number

Area CodePhone Number

Alt. Phone Number

Area CodePhone Number

Does the participant have any allergies? If yes, please describe.

Is the participant prescribed an inhaler? If yes, please explain any instructions.

Registration$60.00

Quantity

Total $0.00

Consent Acknowledgement

I hereby give my approval for my child’s participation in activities prepared by Down The Middle Foundation. There is a risk of being injured that is inherent in all sports activities and duty of care has been taken to organize events in order to to avoid hazards and ensure a safe environment for all participants and bystanders. In the event of an injury to a participant it’s staff and volunteers will not be held liable unless negligent in carrying out its duties. A COVID Safe management plan is also in place and a DTM representative will be present at all activities.

DTM Photo Release

I, parent or guardian of a Down the Middle player, agree and consent to the following:

Down the Middle may use my likeness in any photograph, video or other digital media taken or to be taken during an event in any and all of its publications, including print or web-based publications.

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Signature

Pay with PayPal

First Name

Last Name

Credit Card Number

Security Code

Card Expiration

Please click one of the PayPal options to complete payment and submit the form.