Youth Flag Football Camp Waitlist
Thank you for registering. Due to limited spots, your submission will been placed on the waitlist unless you received your Event Brite ticket before July 7th. We will notify you if a spot becomes available.
Parent/Guardian Information
Parent/Guardian Full Name
*
First Name
Middle Name
Last Name
Relationship to Child
*
Email Address
*
example@example.com
Primary Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Alternate Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Home Address
Emergency Contact Name
*
Emergency Contact Relationship
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Participant Information
Child's Full Name
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Age
*
Gender
*
Male
Female
Prefer Not to Say
Other
Grade (Upcoming School Year)
*
School Name
T-Shirt Size
*
Youth XS
Youth S
Youth M
Youth L
Youth XL
Adult S
Adult M
Adult L
Adult XL
Adult XXL
Previous Flag Football Experience
None
Beginner
Intermediate
Advanced
Medical Information
Medical Conditions, Allergies, or Special Needs
Current Medications
Physician Name
Physician Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Photo & Media Release
*
Yes, I grant permission
No, I do not grant permission
Volunteer Coach Interest
Are you interested in either Volunteering or Coaching?
Yes
No
Waiver Agreement
I certify that I am the parent or legal guardian of the participant listed in this registration. I understand that participation in flag football involves physical activity and inherent risks of injury. I authorize my child to participate in all camp activities and assume all risks associated with participation. I release and hold harmless Life Prep Academy Foundation, its directors, officers, employees, volunteers, sponsors, partners, and facility providers from any claims arising from participation except as otherwise provided by law. I authorize emergency medical treatment if I cannot be reached. I also grant permission for photographs and video recordings of my child to be used for promotional and educational purposes unless I specifically opt out in writing.
*
I Agree
Signature
*
eventbrite_order_id
Source
ticket_email
eventbrite_event_id
ticket_quantity
parent_key
return_url
registration_type
previous_child_count
MM/DD/YY-HH:MM timestamp
Submit
Should be Empty: