Please fill out the registration form to participate in the event, including team details and participant information.
Registration Type
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Please Select
Clinic Division
Game Division
Team Name
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Team Roster
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Parent/Guardian Name
*
Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Team Category
*
Please Select
Boys Team
Girls Team
Player Division
*
Please Select
8 & Under (8U)
10 & Under (10U)
12 & Under (12U)
14 & Under (14U)
16 & Under (16U)
18 & Under (18U)
Does any participant have any medical conditions or special needs?
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Yes
No
Please describe the medical conditions, allergies, medications, or special needs we should be aware of.
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Media Release Waiver I hereby grant permission to the City of Riviera Beach Parks & Recreation Department to use photographs, video recordings, or other media of myself or my child(ren) taken during participation in the recreation program(s). These may be used for promotional purposes including, but not limited to, brochures, social media, or the City's website, without compensation.
Media Release Signature
Transportation Waiver I hereby give permission for the City of Riviera Beach Parks & Recreation Department to provide transportation for myself or my child(ren) to and from program activities as needed. I understand that the City, its employees, and any third-party transportation providers shall not be held liable for any incidents, accidents, or injuries that may occur during transportation to or from activities.
Transportation Signature
Waiver and Consent I, the undersigned, hereby release and hold harmless the City of Riviera Beach, a municipal corporation, its officers, agents, and employees from any and all liability, claims, demands, and causes of action arising from participation in the Parks & Recreation Department program(s). I also authorize the staff to secure emergency medical services for the participant when deemed necessary.
Waiver and Consent Signature
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Submit Registration
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