The Free Play Foundation Player Registration Form

PARENT / GUARDIAN INFORMATION
Parent / Guardian Name *

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Mailing Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
I would like to assist my child as their helper/coach during activities.*

YesNo
If Yes, please select your T-Shirt Size

Adult SAdult MAdult LAdult XLAdult XXLAdult 3XL
EMERGENCY CONTACT INFORMATION

Same as Parent/ Guardian
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.
Relationship To Player
THE FREE PLAY FOUNDATION RELEASE FORM
I am the Parent or Guardian of the Free Play Foundation camp participant named below and agree to the following:
1. Able to Participate. The player is physically able to take part in the Free Play Foundation camp.
2. Likeness Release. I give permission to The Free Play Foundation., The Free Play Foundation camp, games organizing committees, and The Free Play Foundation (collectively "The Free Play Foundation ") to use the player's likeness, photo, video, name, voice, words, and biographical information to promote The Free Play Foundation and raise funds for The Free Play Foundation.
3. Emergency Care. If a parent or guardian is unavailable to consent or make medical decisions in an emergency, I authorize The Free Play foundation to seek medical care for the Player, unless I mark one of these boxes:
I have a religious or other objection to receiving medical treatment. (Not common)I do not consent to blood transfusions. (Not common) (If either box is marked, an EMERGENCY MEDICAL CARE REFUSAL FORM must be completed)
4.Risk of Concussion and Other Injury. I know there is a risk of injury. I understand the risk of continuing to participate with or after a concussion or other injury. The Player may have to get medical care if there is a suspected concussion or other injury. The Player also may have to wait 7 days or more and get permission from a doctor before playing sports again.

5. Personal Information. I understand that The Free Play Foundation will be collecting the Player's personal information as part of participation, including name, image, address, telephone number, health information, and other personally identifying and health rela information provided to The Free Play Foundation ("personal information")

I agree and consent to The Free Play
Foundation:
- Using the personal information in order to: confirm eligibility and safe participation; run trainings and events; share competition results (including on the Web and in news media); provide health treatment if the player participates in a health program; analyze data for the purposes of improving programming and identifying and responding to the needs of The Free Play Foundation participants; perform computer operations, quality assurance, testing, and other related activities; and provide event-related services.
- Using the personal information for communications and marketing purposes, including direct digital marketing through email, text message, and social media. osharing personal information with (i) researchers, such as universities and public health agencies, that are studying intellectual disabilities and the impact of The Free Play Foundation activities,(ii) medical professionals in an emergen and (iii) government authorities for the purpose of assisting with any visas required for international travel to The Free Play Foundation events and for any other purpose necessary to protect public safety, respond to government requests, and report information as required by law.
- I have the right to ask to see the personal information or to be informed about the personal information that is processed. I have the right to ask to correct and delete the personal information, and to restrict the processing of personal information if it is inconsistent with this consent.
- Privacy Policy. Personal information may be used and shared consistent with this form and as further explained in the The Free Play Foundation privacy policy at www.thefreeplayfoundation.org
PARENT/GUARDIAN SIGNATURE
I am a parent or guardian of the Player. I have read and understand this form. By signing, I agree to this form on my own behalf and on behalf of the Player.
Parent/ Guardian Name*

First NameLast Name
Parent/ Guardian Signature *

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My Products*

Player Registration Includes all player fees, team party, jersey, and team/ individual photo.

$125.00

Free Play ShirtFree Play Shirt for parents, siblings, etc. (Player's jersey included in registration fee)

$25.00

Product Name

$ Free Quantity

Enter coupon

Total

$0.00

Payment Methods

Credit Card

Apple Pay

Google Pay

Cash App Pay

Date

MonthDayYear
Date
Should be Empty:

The Free Play Foundation Player Registration Form

PARENT / GUARDIAN INFORMATION

THE FREE PLAY FOUNDATION RELEASE FORM

PARENT/GUARDIAN SIGNATURE

Payment Methods