Sports Physical Sign Up, Aug 15 9-11:30

Sports Physical Pre-Registration

Sat Aug 15, 9-11:30 am, The Kroc Center 800 E. Parkway S
Player must be accompanied by parent or adult family member or guardian over 18 years of age in order to be seen by the medical staff. Physicals will be done on a first come, first serve, basis. Space is limited. Please pre-register only if you're confident you can attend.
Player Name

First NameLast Name
Age
School
Parent/Legal Guardian Name

First NameLast Name
Parent/Guardian Phone
Please enter a valid phone number.Format: (000) 000-0000.
Parent/ Guardian Email
example@example.com
Recognizing the possibility of injury, undetected illness, unreported medical issues or medical issues that may occur by participating in sports, I consent to my player participating in this program. I hereby release, discharge, hold harmless, and will indemnify 901 Girls With Goals Inc, involved entities, sponsors, their employees, personnel, and volunteers, including the owner of the facilities utilized for the program from any claim by or on the behalf of my player as a result of my player's physical evaluation and participation in the program.
Parent/Legal Guardian Signature
Should be Empty:

Sports Physical Pre-Registration