1. Sport Registering For:
______________________________________________________________________________________
Please Check Branch:
Cleveland
Hamilton
North Georgia
North River
J.A. Henry
Please Check one:
Spring
Summer
Fall
Winter
Uniform Size (See sample sizes at desk):
YXS
YS
YM
YL
AS
AM
AL
Other
2. Volunteers Needed (please Check all that you might be interested in):
Coach
Assistant Coach
Other
Volunteer
3. Complete the personal information in the box below:
4. How many years has your child played organized sports?: ________
For the balance in forming teams, AT PLAY, your child is best described as:
Mark one
(1-least aggressive to 5-most aggressive)
:
1
2
3
4
5
5. Please list other previous sports experience: _________________________________________________________________
_____________________________________________________________________________________________________________
The YMCA considers all registrations without to race, color, religion, sex, national origin, or the presence of medical condition or handicap. However,
the YMCA does reserve the right to refuse admission to any child who may require a level of attention beyond that which YMCA programs are designed
to accommodate or who may require specialized training that may prevent YMCA staff from adequately meeting the needs of the child. I agree to abide
by the rules and regulations as set forth by the YMCA staff. I will fully accept the decision of the YMCA staff regarding the placement of my child on a
team. I will also conduct myself with a positive Christian attitude toward coaches, opposing team players, officials. And YMCA staff members during the
course of the season. I understand that the YMCA does not provide insurance coverage for the above listed program participant and that I am
responsible for my child’s own personal coverage. I hereby give permission for the Cleveland Family YMCA to use for promotional purposes any photos
or videos taken of my child while involved in this program. By signing my name below, I am indicating that: this registration form is correct to the best of
my knowledge and that child herein described has permission to engage in all prescribed activities expect those noted by me. I understand that YMCA
activities have inherent risks and I hereby assume all risks and hazards incident to my participation in all YMCA activities. I further waive, release, absolve,
indemnify and agree to hold harmless the YMCA, the organizers, volunteers, supervisors, officers, directors, participants, coaches, referees, as well as,
persons or parents transporting participants to and from activities from any claims or injury sustained during my participation in YMCA activities.
Note: Refund requests must be made before the first game. No refunds will be given after the first game. If requesting a refund, there will be a $15.00
administrative fee charged.
PARENT/GUARDIAN SIGNATURE: __________________________________________________________ DATE: _____________
YOUTH SPORTS
REGISTRATION FORM
Date: _____________________
Member #: ________________
Amount paid: $_____________
Receipt #: _________________
Parent Email address: _______________________________________________________________________________________
Please ensure that you include an email address (Primary form of communication).
Childs (FULL) name: __________________________________________________ Sex
M
F Age: ____ DOB: _________
Best contact number: ______________________________ School attending: _______________________________________
Home address: ____________________________________ City: ______________________ State: _____ Zip: _____________
Mother's name: _________________________________ DOB: __________ Employer: _________________________________
Cell phone number: _____________________________
_____
Work phone number: ___________________________________
Father's name: ________________________
__________
DOB: __________ Employer: _________________________________
Cell phone number: _____________________________
_____
Work phone number: ___________________________________
Siblings participating: (1) ________________________ (2)________________________ (3)________________________
click to sign
signature
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