26’ Spring Skill Development

CSAT/THE UN1T

SKILL DEVELOPMENT SESSIONS
Student Name*

First NameLast Name
Grade*
Age*
Birthdate*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Guardian / Parent Name*

First NameLast Name
Parent Cell Phone*
Format: (000) 000-0000.
Parent Email:*
example@example.com
Emergency Contact & Health Insurance Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*
Format: (000) 000-0000.
YesNo
Please describe (if unknown type NA)*
Release of Liability

Although the safety of all sport activities is the primary concern, Basketballl activities at Charter School for Applied Technology facility may cause injuries and/or death. I expressly assume the risk of injury, death, and/or illness arising from any cause, and agree to waive the right to pursue any claim against The Unit Promise and Charter School for Applied Technology.
YesNo
Confirmation E-mail*
example@example.com
Should be Empty:

CSAT/THE UN1T