Clone of 2025 DTM CAMP

Player's Information

Name

First NameLast Name

Birth Date

MonthDayYear

Gender

MaleFemaleOther

Address

Street Address

Street Address Line 2

CityState

Postal CodeCountry

School

Grade

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.

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.

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

Trick or Training$25.00

Quantity

Total $0.00

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