Star Wars: The Mandalorian & Grogu Movie Premiere Special Needs 11:00AM
Saturday, May 30th - Location: Studio Movie Grill 8440 S Sam Houston Pkwy E, Houston, TX 77075 * Listing your name as a parent does not reserve your seat. Everyone attending- child, parent, sibling, or caretaker must register separately.
Name of Event
*
Email
*
example@example.com
Participant's Name
*
Gender
*
Male
Female
Other
Race
*
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Pacific Islander
White
Other
Date of Birth
*
-
Month
-
Day
Year
Participant's Parent/Guardian Name
*
Home Address
*
Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Alternate Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Any medical conditions or food allergies?
*
Emergency Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
School
*
Grade
*
T-Shirt Size
*
XS
S
M
L
XL
XXL
THE PARENT/GUARDIAN OF THE ABOVE NAME CHILD, HEREBY GIVE MY APPROVAL OF HIS/HER PARTICIPATION IN ALL BASKETBALL/SPORTING ACTIVITIES. I ASSUME ALL RISKS AND HAZARDS INCIDENTAL TO SUCH PARTICIPATION. I DO HEREBY WAIVE, RELEASE, ABSOLVE AND AGREE TO HOLD THIS FACILITY AND BE A NINTH WONDER FOUNDATION, INC, COACHES AND OFFICIALS FROM ANY CLAIMS WHICH MIGHT ARISE FROM INJURIES SUSTAINED WHILE PARTICIPATING IN THIS EVENT. PICTURES AND VIDEOS WILL BE TAKEN DURING EVENTS. THEREFORE I/WE THE PARENT/GUARDIAN OF THE ABOVE NAME PARTICIPANT, GIVE BE A 9TH WONDER FOUNDATION PERMISSION TO USE THE ABOVE NAME PARTICIPANT’S PICTURE AND OR VIDEO ON WEBSITES (SUCH AS FACEBOOK, INSTAGRAM OR OTHER SOCIAL MEDIA ENTITIES) TAKEN DURING TRAINING SESSIONS,CAMPS OR WORKOUTS FOR PROMOTION PURPOSES ONLY.
*
CHECK HERE IF YOU AGREE
For grant purposes, please indicate your household income
*
Below 30,000 annually
31,000-50,000 annually
Above 51,000 annually
Please read and agree COVID-19 Safety Acknowledgement And Liability Waiver https://ninthwonder.org/covid-19-safety-acknowledgement-and-liability-waiver/
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CHECK HERE IF YOU AGREE
A copy of your responses will be emailed to the address that you provided.
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