YOUR INVITED TO TRYOUT FOR TEAM IGLOO LACROSSE

Size: px
Start display at page:

Download "YOUR INVITED TO TRYOUT FOR TEAM IGLOO LACROSSE"

Transcription

1 YOUR INVITED TO TRYOUT FOR TEAM IGLOO LACROSSE

2 Team Igloo Lacrosse Tryouts 2/3 rd Grade Boys Sunday, January 30 th, :30 AM to 9 AM (Warm-ups Begin at 7AM) At Mitchell Field Indoor Facility (Rough Riders) Cost: $20 per player TRYOUT OUT HIGHLIGHTS Evaluators will rank the kids on the following: Cradling Catching Throwing Dodging Speed and Agility Knowledge of the game Please be at the facility at 7AM to get them dressed and to submit your registration form and wavier and your son will receive a tryout #. Warm-ups start at 7AM and official tryout will begin at 7:30AM. What To Bring White/dark reversible jersey No Cleats/Indoor Shoes Only Must have mouth piece and all equipment to tryout Water Bottle Directions to Mitchell Field- Rough Riders Training Facility 120 Charles Lindbergh Blvd. Uniondale, NY Tel: ext 11 Tel: From the East: Take Meadowbrook Parkway to Hempstead Tpke/Coliseum exit (M4). Take "Charles Lindbergh Boulevard" turn-off on service road if proceeding south on Meadowbrook or "Coliseum" turn-off on service road if proceeding north on Meadowbrook. Follow Charles Lindbergh Boulevard past Coliseum. Continue past Omni office building to Mitchell Complex parking lot on left. Training Center is located to your right as you enter parking lot.

3 Team Igloo Tryouts Registration Form Tryout # Coaches Only Use Child and Guardian Information Childs Full Name: Street Address: City, State, Zip: Home Phone: 1 st Guardian Full Name: Cell Phone: Alternative Phone: Address: Player Profile Please circle where applied Age: Grade: 2 nd or 3 rd Grade US Lacrosse #: Strong Hand: Lefty or Righty Preferred Positions: Attack Midfield Defense Goalie Do you Play PAL? Yes or No Town:

4 WAIVER AND RELEASE BY PARENT OF MINOR CHILD FROM LIABILITY FOR LACROSSE I,, on behalf of (hereinafter referred to as CHILD ) HEREBY WAIVE AND RELEASE, indemnify, hold harmless and forever discharge Igloo Lacrosse, Inc and its agents, managers, employees, officers, directors, affiliates, successors and assigns, of and from any and all claims, demands, debts, contracts, expenses, causes of action, lawsuits, damages and liabilities, of every kind and nature, whether known or unknown, in law or equity, that I or CHILD ever had or may have, arising from or in any way related to CHILD S participation in any of the events or activities conducted by, on the premises of, or for the benefit of, Igloo Lacrosse, Inc provided that this waiver of liability does not apply to any acts of gross negligence, or intentional, willful or wanton misconduct. I understand that the activities that said CHILD will participate in are inherently dangerous and may cause serious or grievous injuries, including bodily injury, damage to personal property and/or death. On behalf of myself, CHILD, my heirs, assigns and next of kin, I and said CHILD waive all claims for damages, injuries and death sustained to me or my property, that I or said CHILD may have against the aforementioned released party to such activity. CHILD has the necessary and requisite skills to participate in all facets of, and activities of and requested of this club, except as noted below. The nature of the activities has been fully disclosed and any flyer, advertisement, or brochure relating to the participating activities is expressly made a part of this WAIVER AND RELEASE. I further agree and warrant that if at any time I believe conditions to be unsafe, I will immediately exercise my parental/guardianship rights and discontinue further participation by said CHILD in the activity. By this Waiver, I, on behalf of said CHILD, assume any risk, and take full responsibility and waive any claims of personal injury, death or damage to personal property associated with Igloo Lacrosse, Inc including but not limited to receiving lacrosse lessons at the facility/club/courts, using the facility/club/courts and its equipment in any manner, form or fashion, and practicing and/or engaging in lacrosse activities, round robins, ladders, leagues, tournaments, drills or other related activities on and off the premises. This WAIVER AND RELEASE contains the entire agreement between the parties, and supersedes any prior written or oral agreements between them concerning the subject matter of this WAIVER AND RELEASE. The provisions of this WAIVER AND RELEASE may be waived, altered, amended or repealed, in whole or in part, only upon the prior written consent of all parties. The provision of this WAIVER AND RELEASE will continue in full force and effect even after the termination of the activities conducted by, on the premises of, or for the benefit of, Igloo Lacrosse, Inc whether by agreement, by operation of law, or otherwise. I have read, understand and fully agree to the terms of this WAIVER AND RELEASE. I understand and confirm that by signing this WAIVER AND RELEASE said CHILD and I have given up considerable future legal rights. I have signed this Agreement freely, voluntarily, under no duress or threat of duress, without inducement, promise or guarantee being communicated to me. My signature is proof of my intention to execute a complete and unconditional WAIVER AND RELEASE of all liability to the full extent of the law. Medical Conditions. CHILD is subject to the following allergies or medical conditions, and I authorize the facility to disclose these conditions to a physician or other medical professional in the event said CHILD should require emergency medical care: Prohibited Activities. As a result of the above-mentioned medical conditions, I, on behalf of said CHILD, am prohibiting involvements in the following specific activities: (Date) (Printed Name of CHILD) (Printed Name of Parent/Guardian ) (Signature of Parent/Guardian )

5 Team Igloo Uniforms

6 Team Igloo Lacrosse Making the Team Team Igloo Lacrosse will be a considerable commitment. Your son or sons will be committing to a Spring and Summer season which will not interfere with your Town PAL league. Below are the expectations for each player once you have been notified via that your son has made the team. Expectations Spring Commitment 10 Games On Saturdays (Oyster Bay League) Schedule not yet released. Practice Once A Week on Thursdays at Robins Lane Turf Field from 6 to 8PM starting in late February early March. Summer Tournament Commitments 1. Andy Forsberg Tournament (Huntington) Dates: 6/11 6/12 (Huntington) 2. Lehigh Lax fest (Pennsylvania) Dates: 6/18 3. LI Lax Fest (Farmingdale) Dates: 6/25-6/26 4. Tri-State (New Jersey) Dates: 7/ Hofstra Blue and Gold Classic (Hempstead) Dates: 7/15-7/17 Practices We will conduct practices once a week on Thursdays at Robins Lane Turf Field from 6 to 8PM starting as soon as the weather permits Robbins Lane Jericho, NY Financial Commitment $1,200 Per Player Full Payment is Due by February 12 th, 2011 Make Checks Payable to: Igloo Lacrosse, Inc. 25 Hillside Lane Syosset, NY 11791

2017 Multi-Jurisdictional Law Enforcement Explorer Academy

2017 Multi-Jurisdictional Law Enforcement Explorer Academy 2017 Multi-Jurisdictional Law Enforcement Explorer Academy All questions must be answered. If something does not apply please indicate N/A. Note: If there are any un-answered questions on this application

More information

2018 BALTIMORE RAVENS CHEERLEADER APPLICATION

2018 BALTIMORE RAVENS CHEERLEADER APPLICATION PRELIMINARY # OFFICE USE ONLY 2 ND ROUND # LAST FIRST 2018 BALTIMORE RAVENS CHEERLEADER APPLICATION IN ORDER TO PROCESS YOUR APPLICATION WE NEED THIS INFORMATION FROM YOU: 1. A $25.00 check or money order

More information

Champion Cheer All-Stars Inc., Falls City, Nebraska Waiver of Liability, Release, Indemnity, and Assumption of Risk Agreement Name of participant: In

Champion Cheer All-Stars Inc., Falls City, Nebraska Waiver of Liability, Release, Indemnity, and Assumption of Risk Agreement Name of participant: In Champion Cheer All-Stars Inc., Falls City, Nebraska Waiver of Liability, Release, Indemnity, and Assumption of Risk Agreement Name of participant: In consideration of the services of Champion Cheer All-Stars

More information

PARENT AGREEMENT FOR USE OF THIRD-PARTY TRANSPORTATION SERVICE. Rules and Guidelines

PARENT AGREEMENT FOR USE OF THIRD-PARTY TRANSPORTATION SERVICE. Rules and Guidelines PARENT AGREEMENT FOR USE OF THIRD-PARTY TRANSPORTATION SERVICE Yeshiva Elementary, Inc. has arranged with a third-party vendor to provide bus transportation for students to and from Yeshiva Elementary

More information

2018 Jr. Celtics Two-day Winter Break Clinic Registration Form

2018 Jr. Celtics Two-day Winter Break Clinic Registration Form 2018 Jr. Celtics Two-day Winter Break Clinic Registration Form For more information call 617-399-8432 or email Sam at: jrceltics@celtics.com When: Thursday, December 27, 2018 Friday, December 28, 2018

More information

Oklahoma City University Travel Waiver and Release Agreement

Oklahoma City University Travel Waiver and Release Agreement Oklahoma City University Travel Waiver and Release Agreement Introduction: Oklahoma City University allows employees and students to participate in activities that may involve or require travel outside

More information

Diana Golden Race Maine Adaptive Sports & Recreation Sunday River, ME January 15, Race Schedule

Diana Golden Race Maine Adaptive Sports & Recreation Sunday River, ME January 15, Race Schedule Diana Golden Race Maine Adaptive Sports & Recreation Sunday River, ME January 15, 2018 Race Schedule Location 8:00 8:45 Race Registration Maine Adaptive 8 Sundance Ln, Newry 9:00-9:45 Course Inspection

More information

TEAM ONALYSIS Hosts A USATF Sanctioned Cross Country Meet at Golden Gate Park, Polo Fields in San Francisco Sunday, October 28, 2018

TEAM ONALYSIS Hosts A USATF Sanctioned Cross Country Meet at Golden Gate Park, Polo Fields in San Francisco Sunday, October 28, 2018 TEAM ONALYSIS Hosts A USATF Sanctioned Cross Country Meet at Golden Gate Park, Polo Fields in San Francisco Sunday, October 28, 2018 Schedule: 8:00 am 9:00 am Registration 9:00 am Course Walk 10:00 am

More information

2018 Bob Richey Team Camp

2018 Bob Richey Team Camp Coaches Information Form School Name: School Phone: School Address: Head Coach: Cell Number: Assistant Coach: Cell Number: Assistant Coach: Cell Number: Assistant Coach: Cell Number: Statement of Coach

More information

69 th Annual Michigan-Wisconsin Tennis Open

69 th Annual Michigan-Wisconsin Tennis Open 69 th Annual Michigan-Wisconsin Tennis Open August 6 & 7, 2016 FEES: Singles is $18 and doubles is $22 per team (includes t-shirt). Checks should be made payable to Esky Tennis. Entry forms should be mailed

More information

Registration Form. Our Lady of Guadalupe High School Retreat. February 23 25, 2018 Camp Zephyr, Sandia, TX Cost: $140.00

Registration Form. Our Lady of Guadalupe High School Retreat. February 23 25, 2018 Camp Zephyr, Sandia, TX Cost: $140.00 Registration Form Our Lady of Guadalupe High School Retreat February 23 25, 2018 Camp Zephyr, Sandia, TX Cost: $140.00 For Office Use Only Paid: YES NO Cash Check ($140.00 covers roundtrip bus transportation

More information

Youth Police Academy C/O: Clare Police Department 207 W. Fifth Street Clare, MI (989) Membership Application 2017

Youth Police Academy C/O: Clare Police Department 207 W. Fifth Street Clare, MI (989) Membership Application 2017 Youth Police Academy C/O: Clare Police Department Membership Application 2017 07-10-2017 07-20-2017 Monday - Thursday for 2 weeks 8am - 4pm $15 Non Refundable Application Fee Required (Cash Preferred -

More information

WESTMORELAND ELITE VOLLEYBALL CLUB Participation Agreement Season

WESTMORELAND ELITE VOLLEYBALL CLUB Participation Agreement Season WESTMORELAND ELITE VOLLEYBALL CLUB Participation Agreement 2018-2019 Season Section 1 Conditions of participation We, the parents/guardians of have read the enclosed information concerning the policies

More information

Candidate Pack. RBNY Training Facility, NJ

Candidate Pack. RBNY Training Facility, NJ Candidate Pack RBNY Training Facility, NJ Dear Candidate, You are confirmed for the New York Red Bull s interview day at the New York Red Bulls Training Facility, New Jersey. Please read the attached information

More information

RELEASE AND WAIVER OF LIABILITY Sports Authority Football Field Day

RELEASE AND WAIVER OF LIABILITY Sports Authority Football Field Day ATTENTION: Please print all waivers and bring signed and completed waivers to the event. Individuals without signed waivers will not be able to participate in event. RELEASE AND WAIVER OF LIABILITY Sports

More information

PARTICIPANT S REPRESENTATIONS, EXPRESS ASSUMPTION OF ALL RISKS & RELEASE OF LIABILITY AGREEMENT FOR OAK RIDGE HIGH SCHOOL PERFORMANCE TRAINING CENTER

PARTICIPANT S REPRESENTATIONS, EXPRESS ASSUMPTION OF ALL RISKS & RELEASE OF LIABILITY AGREEMENT FOR OAK RIDGE HIGH SCHOOL PERFORMANCE TRAINING CENTER Page 1 of 5 PARTICIPANT S REPRESENTATIONS, EXPRESS ASSUMPTION OF ALL RISKS & RELEASE OF LIABILITY AGREEMENT FOR OAK RIDGE HIGH SCHOOL PERFORMANCE TRAINING CENTER Purpose of This Binding Agreement By signing

More information

Registration Form Please Check: Boy Girl Age: Camper s Name: Address: City: State: Zip Code:

Registration Form Please Check: Boy Girl Age: Camper s Name: Address: City: State: Zip Code: Registration Form Please Check: Boy Girl Age: Camper s Name: Address: City: State: Zip Code: Contact Name: Emergency Contact Number: Alt. Emergency Contact Number: E-Mail Address: Signature: Alt. Contact

More information

Instructions for Completing Waivers

Instructions for Completing Waivers Instructions for Completing Waivers 1) Print out all four (4) forms attached. 2) All 4 forms must be filled in COMPLETELY. If forms are not completed and signed properly your minor child will not be allowed

More information

Candidate Pack. RBNY Training Facility, NJ

Candidate Pack. RBNY Training Facility, NJ Candidate Pack RBNY Training Facility, NJ Dear Candidate, You are confirmed for the New York Red Bull s interview day at the New York Red Bulls Training Facility, New Jersey. Please read the attached information

More information

Volunteer Forms Packet

Volunteer Forms Packet Volunteer Forms Packet INSTRUCTIONS FOR COMPLETING VOLUNTEER FORMS 1. Individuals must complete and sign 2 forms: Volunteer form (page 2) Release and Waiver of Liability form (page3 & 4) 2. All volunteers

More information

2017 U14 Eastern Championships All information subject to change

2017 U14 Eastern Championships All information subject to change LOCATION: Sunday River, Maine For directions go to web address www.sundayriver.com SCHEDULE: Registration March 15, 2017 4PM-6:30PM at Grand Summit Hotel- Simmonds 7PM Team Captains Meeting at Gould Academy

More information

Wise County Law Enforcement Explorers Post 500

Wise County Law Enforcement Explorers Post 500 Wise County Law Enforcement Explorers Post 500 1007 13 th Street Suite 101 Bridgeport, Texas 76426 MEMBERSHIP APPLICATION Failure to properly and thoroughly complete this document may result in the rejection

More information

2017 BALTIMORE RAVENS CHEERLEADER APPLICATION

2017 BALTIMORE RAVENS CHEERLEADER APPLICATION PRELIMINARY # OFFICE USE ONLY 2 ND ROUND # LAST FIRST 2017 BALTIMORE RAVENS CHEERLEADER APPLICATION IN ORDER TO PROCESS YOUR APPLICATION WE NEED THIS INFORMATION FROM YOU: 1. A $25.00 check or money order

More information

DAZZLE AFRICA RELEASE OF LIABILITY, INDEMNITY, AND AGREEMENT

DAZZLE AFRICA RELEASE OF LIABILITY, INDEMNITY, AND AGREEMENT DAZZLE AFRICA RELEASE OF LIABILITY, INDEMNITY, AND AGREEMENT This Release of Liability, Indemnity, and Agreement (the Agreement ) is entered into by and between the parties described in the next two paragraphs:

More information

RAMS HILL RACQUET AND SWIM CLUB ASSUMPTION OF RISK AND RELEASE AGREEMENT

RAMS HILL RACQUET AND SWIM CLUB ASSUMPTION OF RISK AND RELEASE AGREEMENT RAMS HILL RACQUET AND SWIM CLUB ASSUMPTION OF RISK AND RELEASE AGREEMENT I, ("Member"), acknowledge that I have voluntarily applied for membership in the Rams Hill Racquet and Swim Club ("Club") at the

More information

BRIDIE McCANN MEMORIAL RACE 1K OPEN WATER SWIM Sunday, August 10, 2014

BRIDIE McCANN MEMORIAL RACE 1K OPEN WATER SWIM Sunday, August 10, 2014 BRIDIE McCANN MEMORIAL RACE 1K OPEN WATER SWIM Sunday, August 10, 2014 When: 11:00 am 12:00 pm Check-in & numbering 12:30 pm Pre-race meeting* 1:00 pm Race starts *Note: The pre-race meeting is mandatory

More information

Southeast Schooling Show Championships Chattahoochee Hills October 7 th and 8 th

Southeast Schooling Show Championships Chattahoochee Hills October 7 th and 8 th Opening Date: August 15, 2017 Closing Date: September 18th, 2017 Southeast Schooling Show Championships Chattahoochee Hills October 7 th and 8 th Show: 10045 Cedar Grove Road, Chattahoochee Hills, GA 30213

More information

Cranston Parks & Recreation Playground Program

Cranston Parks & Recreation Playground Program Cranston Parks & Recreation Playground Program Please print clearly! *FOR OFFICE USE ONLY* School & Age Check # Birth Certificate Proof of Residency Health Insurance Child s Name Age Address City Zip Code

More information

ARTICLE I - NAME The name of this organization shall be Ice Dogs Youth Hockey operating out of Hatfield, Pennsylvania.

ARTICLE I - NAME The name of this organization shall be Ice Dogs Youth Hockey operating out of Hatfield, Pennsylvania. Ice Dogs Youth Hockey, Inc. ICE DOGS HOCKEY ICE DOGS HOCKEY By-Laws -- April 2003 Voted in and approved on April 17, 2003 ARTICLE I - NAME The name of this organization shall be Ice Dogs Youth Hockey operating

More information

Medical and Liability Release Form 2018

Medical and Liability Release Form 2018 Please Print Clearly Medical and Liability Release Form 2018 Name: Today s Date: Birthday: Age: Current Grade: Address: City: State: Zip Code: Parent/Guardian: Phone: Parent Email: Emergency Contact: Relationship

More information

Registration Form Please Check: Boy Girl Age: Camper s Name: Address: City: State: Zip Code:

Registration Form Please Check: Boy Girl Age: Camper s Name: Address: City: State: Zip Code: Registration Form Please Check: Boy Girl Age: Camper s Name: Address: City: State: Zip Code: Contact Name: Emergency Contact Number: Alt. Emergency Contact Number: E-Mail Address: Alt. Contact Name: Check

More information

GRACIE GARAGE PARTICIPANT ASSUMPTION OF RISK, CONSENT TO PARTICIPATION, WAIVER OF LIABILITY AND RELEASE OF CLAIMS, AND INDEMNIFICATION AGREEMENT

GRACIE GARAGE PARTICIPANT ASSUMPTION OF RISK, CONSENT TO PARTICIPATION, WAIVER OF LIABILITY AND RELEASE OF CLAIMS, AND INDEMNIFICATION AGREEMENT GRACIE GARAGE PARTICIPANT ASSUMPTION OF RISK, CONSENT TO PARTICIPATION, WAIVER OF LIABILITY AND RELEASE OF CLAIMS, AND INDEMNIFICATION AGREEMENT READ BEFORE SIGNING In consideration of you being permitted

More information

JOIN US AT OUR NEXT DUI CHECKPOINT: BEHIND THE LINE

JOIN US AT OUR NEXT DUI CHECKPOINT: BEHIND THE LINE JOIN US AT OUR NEXT DUI CHECKPOINT: BEHIND THE LINE The Santa Ana Police Department would like to invite residents, students, and community members who are interested in attending a Driving Under the Influence

More information

ASSUMPTION OF RISK, RELEASE AND LIABILITY WAIVER

ASSUMPTION OF RISK, RELEASE AND LIABILITY WAIVER ASSUMPTION OF RISK, RELEASE AND LIABILITY WAIVER This Event may involve serious risk of injury. I understand that by signing this form, I am giving up the right to sue if I am injured while participating

More information

PARENTAL CONFIRMATION AGREEMENT

PARENTAL CONFIRMATION AGREEMENT PARENTAL CONFIRMATION AGREEMENT THIS AGREEMENT AND THE ENCLOSED EVENT RELEASE, WAIVER AND INDEMNITY AGREEMENT (EXHIBIT B) EACH NEED TO BE FULLY COMPLETED AND NOTARIZED FOR MINORS UNDER 18 YEARS OF AGE

More information

BERKS KIDS GOT TALENT

BERKS KIDS GOT TALENT BERKS KIDS GOT TALENT Application and Guidelines The Children s Dyslexia Center of Reading is sponsoring a talent contest featuring the youth of Berks County. All proceeds derived from the contest will

More information

Release and Waiver of Liability

Release and Waiver of Liability Release and Waiver of Liability PLEASE READ CAREFULLY! THIS IS A LEGAL DOCUMENT THAT AFFECTS YOUR LEGAL RIGHTS! This Release and Waiver of Liability (the Release ) is executed on this day of, 20, by, (the

More information

I, the Volunteer, hereby freely, voluntarily and without duress execute this Release under the following terms:

I, the Volunteer, hereby freely, voluntarily and without duress execute this Release under the following terms: Volunteer Agreement, Release and Waiver of Liability Updated February 2017 PLEASE READ CAREFULLY! THIS IS A LEGAL DOCUMENT THAT AFFECTS YOUR LEGAL RIGHTS! This Release and Waiver of Liability (the Release

More information

REGISTRATION CHECK LIST & POLICIES

REGISTRATION CHECK LIST & POLICIES REGISTRATION CHECK LIST & POLICIES Online Registration: Register the number of students and adults that will come to camp. A $50 nonrefundable deposit is due per person. Registration Rates: Until March

More information

EQUESTRIAN CONNECTION ELEMENTARY/JUNIOR HIGH SOCIAL EVENT

EQUESTRIAN CONNECTION ELEMENTARY/JUNIOR HIGH SOCIAL EVENT EQUESTRIAN CONNECTION ELEMENTARY/JUNIOR HIGH SOCIAL EVENT Join us for horseback riding, grooming, art activities and games, and a pizza dinner! Friday, May 19, 2017 3:00 p.m. 6:45 p.m. Students will take

More information

2015 BALTIMORE RAVENS PLAYMAKERS APPLICATION

2015 BALTIMORE RAVENS PLAYMAKERS APPLICATION CHECK # PRELIMINARY # LAST LAST FIRST OFFICE USE ONLY OFFICE USE ONLY FIRST 2015 BALTIMORE RAVENS PLAYMAKERS APPLICATION IN ORDER TO PROCESS YOUR APPLICATION WE NEED THIS INFORMATION FROM YOU: 1. A $30.00

More information

DungeonofPrideClothing.com. Bench Only & Full Power (All Men s Open lifters):

DungeonofPrideClothing.com. Bench Only & Full Power (All Men s Open lifters): 2017 UPA Powerlifting & Bench Press National Championship April 22 nd & 23 rd, 2017 XPC Arnold Classic Qualifier & GPC Worlds Qualifier Updated on 8/7/2016 MEET DIRECTOR: Bill Carpenter - President - 563-599-1390

More information

2018 IBS 600 YARD NATIONAL CHAMPIONSHIPS BENCHREST RIFLE CLUB OF ST. LOUIS WRIGHT CITY, MISSOURI OCTOBER 6 & 7, 2018

2018 IBS 600 YARD NATIONAL CHAMPIONSHIPS BENCHREST RIFLE CLUB OF ST. LOUIS WRIGHT CITY, MISSOURI OCTOBER 6 & 7, 2018 2018 IBS 600 YARD NATIONAL CHAMPIONSHIPS WRIGHT CITY, MISSOURI OCTOBER 6 & 7, 2018 The deadline for pre-registration is September 6, 2018, per IBS Long Range Rulebook. Please mail the completed Registration

More information

Chamber Bed Race Rules

Chamber Bed Race Rules Chamber Bed Race Rules We know you hate it but we have to have them! Bed Design Beds must measure at least 3 feet wide by 6 feet long, but no more than 6 feet wide by 8 feet long handles included. (This

More information

The AMA and Minors. To summarize- to sign a minor up you will need either-

The AMA and Minors. To summarize- to sign a minor up you will need either- The AMA and Minors In any AMA event, anywhere in the US, and in any discipline, if the rider is under the age of majority, which in California is 18, that rider cannot enter any AMA race all by him/herself,

More information

Registration Form. Camper Information. Camper s Name: Camper s Gender: Camper s Age (as of June 1, 2018): Parent s/guardian s Name(s)

Registration Form. Camper Information. Camper s Name: Camper s Gender: Camper s Age (as of June 1, 2018): Parent s/guardian s Name(s) Registration Form 2018 HEAT Camp spaces are limited and available on a first-come, first-served basis. Payment is required in full to reserve a space for your child. This registration form must be completed

More information

REGISTRATION CHECKLIST

REGISTRATION CHECKLIST REGISTRATION CHECKLIST June 17-21 Northern Virginia Online Registration: Register the number of students and adults that will come to camp. A $300 non-refundable deposit is due per church to cover ministry

More information

Escambia County Sheriff's Office

Escambia County Sheriff's Office Escambia County Sheriff's Office Law Enforcement Recruit Packet Please fill out the entire packet before turning in. Escambia County Sheriff's Office Recruitment Form Name:_ Last First Middle Address:

More information

Membership Application

Membership Application Membership Application Applicant: Name of Spouse: Home Address: Email: Business: Address: Sponsored By: Additional Reference: Applicant Signature: _ Date of Birth: Date of Birth: Home Tel: Home Fax: Cell

More information

OWNER'S NAME HORSES NAME MAILING ADDRESS PROVINCE POSTAL CODE PHONE NUMBER ARE YOU AN NSEF PROV CHAMP ENTRY CIRCLE YES OR NO

OWNER'S NAME HORSES NAME MAILING ADDRESS PROVINCE POSTAL CODE PHONE NUMBER  ARE YOU AN NSEF PROV CHAMP ENTRY CIRCLE YES OR NO 2018 HANTS COUNTY EXHIBITION -- LIGHT HORSE ENTRY FORM - A SEPARATE ENTRY FORM IS TO BE USED FOREACH HORSE/PONY ENTERED MAIL ENTRIES TO: HANTS COUNTY EXHIBITION, P.O. BOX 368, WINDSOR, N.S. OR FAX 902-798-2999

More information

HEALTH INFORMATION AND CONSENT FOR EMERGENCY MEDICAL TREATMENT FORM. Program Attending: Date of Program: Name of Student or Minor Child: Birth Date:

HEALTH INFORMATION AND CONSENT FOR EMERGENCY MEDICAL TREATMENT FORM. Program Attending: Date of Program: Name of Student or Minor Child: Birth Date: University of Northern Iowa Expanding Your Horizons In Science and Mathematics Conference 10/13/2018 Industrial Technology Campus HEALTH INFORMATION AND CONSENT FOR EMERGENCY MEDICAL TREATMENT FORM Program

More information

early registration ends September 4

early registration ends September 4 Greenwood village kids triathlon Sunday, September 16 Beginning 8:30am ages 5-16 early registration ends September 4 win new p.e. equipment for your school! Prizes sponsored by Greenwood Pediatrics for

More information

SACRED. Transformations. Application for Tattoo Transformation Program

SACRED. Transformations. Application for Tattoo Transformation Program Application for Tattoo Transformation Program Personal Information Name: Address: City: State: Zip Code: Phone: Email: Age: Date of Birth: / / Primary Language: Secondary language: Emergency Contact Information:

More information

OFFICIAL ENTRY FORM ENTRY FEE: $250 / DEADLINE FRIDAY, SEPTEMBER 7 / 5PM PST. Estimated Competition Weight: Height: Age:

OFFICIAL ENTRY FORM ENTRY FEE: $250 / DEADLINE FRIDAY, SEPTEMBER 7 / 5PM PST. Estimated Competition Weight: Height: Age: OFFICIAL ENTRY FORM ENTRY FEE: $250 / DEADLINE FRIDAY, SEPTEMBER 7 / 5PM PST PERSONAL INFORMATION Full Legal Name: E-Mail Address: Mailing Address: City: State: Zip: Day Phone: Cell Phone: Estimated Competition

More information

WELCOME TO THE Y! TORRANCE SOUTH BAY YMCA ADULT #1 EMERGENCY CONTACT. How did you hear about the. Were you referred by a current member?

WELCOME TO THE Y! TORRANCE SOUTH BAY YMCA ADULT #1 EMERGENCY CONTACT. How did you hear about the. Were you referred by a current member? WELCOME TO THE Y! TORRANCE SOUTH BAY YMCA ADULT #1 Address Apt City State Zip Code Email ADULT #2 Phone Number Email DEPENDENTS (17 years old and younger) Phone Number EMERGENCY CONTACT Name Relation to

More information

Camp Pump It Up Registration Form

Camp Pump It Up Registration Form Camp Pump It Up Registration Form Parent/Guardian Name: Child s name: Birth Date: Child s name: Birth Date: Child s name: Birth Date: Email Address: Address: Other adults authorized for pick up: Best phone

More information

ACE of Birmingham Quarter-Year Handbook: 2019 Spring Season

ACE of Birmingham Quarter-Year Handbook: 2019 Spring Season ACE of Birmingham Quarter-Year Handbook: 2019 Spring Season ACE Cheer Company, LLC, strives to help each team member reach or exceed their potential as a competitive cheerleader and as a person. Our program

More information

2016 PREMIER ACADEMY COACH INDEPENDENT CONTRACTOR AGREEMENT

2016 PREMIER ACADEMY COACH INDEPENDENT CONTRACTOR AGREEMENT 2016 PREMIER ACADEMY COACH INDEPENDENT CONTRACTOR AGREEMENT THIS INDEPENDENT CONTRACTOR AGREEMENT ("Agreement") is entered by and between PREMIER BASKETBALL CLUB, a Colorado nonprofit youth sports organization

More information

Annual Cotillion Program

Annual Cotillion Program Annual Cotillion Program 2015-2016 Application Packet DELTA SIGMA THETA SORORITY, INC. COLLIN COUNTY ALUMNAE CHAPTER COTILLION OVERVIEW Cotillion Since the organization's founding, Delta Sigma Theta Sorority,

More information

C-WAGS Sponsored. Scent Trials. Held at: For Your K Cornell Dr. Melrose Park, IL Saturday March 18, 2017

C-WAGS Sponsored. Scent Trials. Held at: For Your K Cornell Dr. Melrose Park, IL Saturday March 18, 2017 C-WAGS Sponsored Scent Trials Held at: For Your K9 1975 Cornell Dr. Melrose Park, IL 60160 Saturday March 18, 2017. Open to all dogs of any breed Including All Americans! Handicapped Handlers and Dogs

More information

State Fair of Virginia

State Fair of Virginia NORTH EAST VIRGINIA DRESSAGE SCHOOLING SHOW at the State Fair of Virginia OCTOBER 3, 2018 WELCOME Dressage Exhibitors & Enthusiasts Come Enjoy a Day featuring Dancing With Horses Musical Exhibitions &

More information

Rider #1 Name Civic P.O. Province Postal Code Phone

Rider #1 Name Civic P.O. Province Postal Code Phone Horse s Name Horse License # Passport Number Performance Hunter 3 3.3 Pre Green Year 1 st. 2 nd. Green Year 1 st. 2 nd, RING # Owner Name Rider #1 Name Rider #2 Name Owner EC # AO or JR Rider 1 EC # AO

More information

First Presbyterian Church CAMP Friday, May 26 th Sunday, May 28 th We are planning to leave the Church by 4:30pm

First Presbyterian Church CAMP Friday, May 26 th Sunday, May 28 th We are planning to leave the Church by 4:30pm First Presbyterian Church CAMP 456 2017 Friday, May 26 th Sunday, May 28 th We are planning to leave the Church by 4:30pm Dear parents, This adventure camp is designed for older elementary students. All

More information

2018 UPA Illinois State & Midwest Powerlifting Championships September 22, 2018

2018 UPA Illinois State & Midwest Powerlifting Championships September 22, 2018 2018 UPA Illinois State & Midwest Powerlifting Championships September 22, 2018 MEET DIRECTORS: Bill Carpenter -UPA President E-mail: Bcarpenter@UPAPower.com Byron Hicks UPA Illinois State Chairman E-mail:

More information

Swimming Classes. REGISTRATION DEADLINE: June 15, 2018

Swimming Classes. REGISTRATION DEADLINE: June 15, 2018 Swimming Classes Sunshine School will partner with Milpitas Star Aquatics to host swim lessons for students in Grades 1 12. Swimming classes will be held in an indoor facility at 1818 Clear Lake Avenue,

More information

Forsyth County Sheriff s Office Sheriff Ron H. Freeman Teen Interception Program

Forsyth County Sheriff s Office Sheriff Ron H. Freeman Teen Interception Program Sheriff Ron H. Freeman APPLICATION FOR ENROLLMENT Non-Mandated Teens Applicant s Name Parent s/legal Guardian s Name Address City, State, and Zip Code Date of Application REV 01/12/15 Page 1 of 7 How to

More information

GET SUMMER TEEN CODE OF CONDUCT

GET SUMMER TEEN CODE OF CONDUCT GET SUMMER TEEN CODE OF CONDUCT The YMCA of Metropolitan Los Angeles is committed to providing a safe and welcoming environment for all members, participants and guests. To promote safety and comfort for

More information

PARTICIPANT APPLICATION & RELEASE WEIGHT LOSS SHOW

PARTICIPANT APPLICATION & RELEASE WEIGHT LOSS SHOW PARTICIPANT APPLICATION & RELEASE WEIGHT LOSS SHOW 1. Please fill out this application and release ( Application and Release ) legibly. 2. Use dark colored ink. 3. Answer all questions honestly and to

More information

The Great Birthday Bake: A Kids Cookie Competition. by DoubleTree by Hilton Cranberry, benefiting Beverly s Birthdays OFFICAL RULES

The Great Birthday Bake: A Kids Cookie Competition. by DoubleTree by Hilton Cranberry, benefiting Beverly s Birthdays OFFICAL RULES EVENT DETAILS The Great Birthday Bake: A Kids Cookie Competition by DoubleTree by Hilton Cranberry, benefiting Beverly s Birthdays OFFICAL RULES What: A Best Cookie baking competition for children under

More information

RELEASE, WAIVER, HOLD HARMLESS, AND INDEMNIFICATION AGREEMENT

RELEASE, WAIVER, HOLD HARMLESS, AND INDEMNIFICATION AGREEMENT RELEASE, WAIVER, HOLD HARMLESS, AND INDEMNIFICATION AGREEMENT Name: Address: Phone: ( ) Email: EMERGENCY CONTACT Name: Phone: ( ) Email: WARNING Under North Carolina law, an equine activity sponsor or

More information

ThUrSDAY, DECEMBER 27. Youth Leader Info. Solid Rock Baptist Church 420 S. White Horse Pike Berlin, NJ We will meet first at:

ThUrSDAY, DECEMBER 27. Youth Leader Info. Solid Rock Baptist Church 420 S. White Horse Pike Berlin, NJ We will meet first at: ThUrSDAY, DECEMBER 27 Youth Leader Info We will meet first at: Solid Rock Baptist Church 420 S. White Horse Pike Berlin, NJ 08009 Evening Schedule 5:00pm 5:30pm Opening Rally Bible Quiz 8:30-11:30pm International

More information

Lakewood Police Explorer Application Packet General Membership Requirements

Lakewood Police Explorer Application Packet General Membership Requirements Lakewood Police Explorer Application Packet General Membership Requirements 1. Applicants must be either 14 years of age and have completed the eighth grade, or between the ages of 15 and 21. 2. Parental

More information

ATV Tour, Waiver and Indemnity Agreement

ATV Tour, Waiver and Indemnity Agreement ATV Tour, Waiver and Indemnity Agreement THIS AGREEMENT made effective as of the day of, 2016. BETWEEN: OUTSY WIDERNESS ADVENTURES INC also known as OUTSY.CA., a Name: Address: Age Driver s License corporation

More information

San Antonio Neighbors

San Antonio Neighbors San Antonio Neighbors 2017 Youth Mission Camp "Recognize that our neighbor is someone as worthy of God's love as I" "Being Jesus" Rejoicing and Sharing God's Love with the World John 3:16-18/2 Corinthians

More information

~LOTUS GUNWORKS OF SOUTH FLORIDA, LLC~ RELEASE, WAIVER, INDEMNIFICATION, HOLD HARMLESS, AND ASSUMPTION OF THE RISK AGREEMENT

~LOTUS GUNWORKS OF SOUTH FLORIDA, LLC~ RELEASE, WAIVER, INDEMNIFICATION, HOLD HARMLESS, AND ASSUMPTION OF THE RISK AGREEMENT ~LOTUS GUNWORKS OF SOUTH FLORIDA, LLC~ RELEASE, WAIVER, INDEMNIFICATION, HOLD HARMLESS, AND ASSUMPTION OF THE RISK AGREEMENT WHEREAS, in return for being allowed to enter Lotus Gunworks, Lotus Gun Range

More information

COLTS NECK SOCCER CLUB POLICIES AND PROCEDURES

COLTS NECK SOCCER CLUB POLICIES AND PROCEDURES COLTS NECK SOCCER CLUB POLICIES AND PROCEDURES 1. PURPOSE 2. MEMBERSHIP/OFFICERS 2.1 Membership 2.2 Elected/Appointed Officers 2.3 Election of Executive Officers 2.4 Voting 2.5 Regular Club Meetings 2.6

More information

RELEASE AND INDEMNIFICATION AGREEMENTS (Adult)

RELEASE AND INDEMNIFICATION AGREEMENTS (Adult) RELEASE AND INDEMNIFICATION AGREEMENTS (Adult) THIS CONSENT, RELEASE, AND INDEMNIFICATION AGREEMENT ( Release ) is entered into by the undersigned in favor of Heritage Park LLC and Indian Valley Stables

More information

Evolution Volleyball 2017 Player Contract

Evolution Volleyball 2017 Player Contract Evolution Volleyball Academy L.L.C. (Evolution) is organized to encourage participation and create a healthy environment for learning volleyball. This binding contract states the obligations of the athletes,

More information

Transportation Services Contract School Year

Transportation Services Contract School Year Transportation Services Contract 2017-2018 School Year 1. Names of Student(s): This agreement is between _(Parent/Guardian) of the above student(s) and Oakcrest School, a District of Columbia corporation

More information

Student Name: Student Phone: Birthday: \ \ Physical Address: Mailing Address: Primary Parent/Guardian:

Student Name: Student Phone: Birthday: \ \  Physical Address: Mailing Address: Primary Parent/Guardian: Z.O.O. Crew Registration Form Registration Deadline: Friday, January 25 th, 2019; Z.O.O. Crew Start Date: Monday, February 4 th, 2019 Limit 30 participants per semester; registrations are first come, first

More information

Pool Membership Agreement

Pool Membership Agreement 2019 Member Name: Member Type: Date: WWW.CHESAPEAKEGOLFCLUB.COM Pool Membership Agreement POOL HOURS Monday Thursday 10:AM 8:PM Fridays 10:AM 10:PM Saturday Sunday 10:AM 8:PM 2019 Pool Membership Rates

More information

Ride-Along Policy and Procedures

Ride-Along Policy and Procedures A 16-137 09/01/16 Ride-Along Policy and Procedures The purpose of this order is to set policy and procedures regarding the San Francisco Police Department's Ride-Along program. The San Francisco Police

More information

VOLUNTEER ASSUMPTION OF RISK, RELEASE OF LIABILITY AND INDEMNITY AGREEMENT FOR: SECOND HARVEST FOOD BANK OF ORANGE COUNTY, INC.

VOLUNTEER ASSUMPTION OF RISK, RELEASE OF LIABILITY AND INDEMNITY AGREEMENT FOR: SECOND HARVEST FOOD BANK OF ORANGE COUNTY, INC. VOLUNTEER ASSUMPTION OF RISK, RELEASE OF LIABILITY AND INDEMNITY AGREEMENT FOR: SECOND HARVEST FOOD BANK OF ORANGE COUNTY, INC. Orange County Harvest 8014 Marine Way, Irvine, CA 92618 (949) 653-2900 Adult

More information

VOLUNTEER ASSUMPTION OF RISK, RELEASE OF LIABILITY AND INDEMNITY AGREEMENT FOR: SECOND HARVEST FOOD BANK OF ORANGE COUNTY, INC.

VOLUNTEER ASSUMPTION OF RISK, RELEASE OF LIABILITY AND INDEMNITY AGREEMENT FOR: SECOND HARVEST FOOD BANK OF ORANGE COUNTY, INC. VOLUNTEER ASSUMPTION OF RISK, RELEASE OF LIABILITY AND INDEMNITY AGREEMENT FOR: SECOND HARVEST FOOD BANK OF ORANGE COUNTY, INC. Orange County Harvest 8014 Marine Way, Irvine, CA 92618 (949) 653-2900 Adult

More information

C ITY OF C H A R L O T T E S V I L L E

C ITY OF C H A R L O T T E S V I L L E C ITY OF C H A R L O T T E S V I L L E Ride-Along Program Guidelines I. You will be in the public eye and should understand that your behavior and dress reflect upon the Charlottesville ; therefore appropriate

More information

R.A. ' ~ ,.r "', ' REGISTRATION AND RELEASE FORM

R.A. ' ~ ,.r ', ' REGISTRATION AND RELEASE FORM ,,.r ",, :0 R.A. SYSTEMS REGISTRATION AND RELEASE FORM Primary Instructor:---- -------------- RELEASE FOR RAPE AGGRESSION DEFENSE SYSTEMS PHYSICAL DEFENSE SYSTEM The undersigned hereby acknowledges to

More information

In this by-law and in all other by-laws of The Cleveland Touring Club, LLC, hereafter passed, unless the context otherwise specifies or requires:

In this by-law and in all other by-laws of The Cleveland Touring Club, LLC, hereafter passed, unless the context otherwise specifies or requires: Cleveland Touring Club LLC By-Laws 17 April 2015 - Final DRAFT Amendment for Member Approval 03 May 2015 Final APPROVED by Membership and Leadership Council 1 ARTICLE I - NAME In this by-law and in all

More information

Giraffes Grades 2nd-3rd. Elephants Grades 3rd-4th

Giraffes Grades 2nd-3rd. Elephants Grades 3rd-4th Resident Non-Resident Warthogs Grades K-1st Giraffes Grades 2nd-3rd Elephants Grades 3rd-4th Lions Grades 4th-5th Teen extreme Grades 6 th -9 th CITY OF SEMINOLE HOLLAND G. MANGUM RECREATION COMPLEX CHILD

More information

Calgary Police Cadet Corps Application

Calgary Police Cadet Corps Application Calgary Police Cadet Corps Application Fostering leadership abilities, cultural tolerance and career development among Calgary s youth. Members of the Corps will define the potential and competence of

More information

SETTLEMENT AND MUTUAL RELEASE AGREEMENT. THIS SETTLEMENT AND MUTUAL RELEASE AGREEMENT ( Agreement ), by

SETTLEMENT AND MUTUAL RELEASE AGREEMENT. THIS SETTLEMENT AND MUTUAL RELEASE AGREEMENT ( Agreement ), by SETTLEMENT AND MUTUAL RELEASE AGREEMENT THIS SETTLEMENT AND MUTUAL RELEASE AGREEMENT ( Agreement ), by and between ARBOR E&T, LLC ( Arbor ) and THE SCHOOL BOARD OF PALM BEACH COUNTY, FLORIDA ( PBC School

More information

Candidate Pack. Metuchen, NJ

Candidate Pack. Metuchen, NJ Candidate Pack Metuchen, NJ Dear Candidate, You are confirmed for the New York Red Bull s interview day at the Sportsplex, Metuchen, New Jersey. Please read the attached information very carefully. If

More information

Seawheeze Weekend 2016 Underage Waiver

Seawheeze Weekend 2016 Underage Waiver Seawheeze Weekend 2016 Underage Waiver 1 IN CONSIDERATION of participating in the SeaWheeze Weekend, activities which may include but are not limited to, registration package pick-up, half-marathon, outdoor

More information

FITNESS CENTER LICENSE AGREEMENT

FITNESS CENTER LICENSE AGREEMENT FITNESS CENTER LICENSE AGREEMENT THIS FITNESS CENTER LICENSE AGREEMENT (the Agreement ), dated as of the date set forth below, is between HCG BLOCK 69 LLC ( Licensor ) and the undersigned ( Licensee ).

More information

Tallcedarsfarm.org Rocky Ridge Road Glen Allen VA 23059

Tallcedarsfarm.org Rocky Ridge Road Glen Allen VA 23059 20 Tallcedarsfarm.org 11353 Rocky Ridge Road Glen Allen VA 23059 Rider s Name Age Date of Birth Male or Female Weight Height Date of Most Recent Physical Examination Riding Experience Style of Riding Parents

More information

Application for Water Service (Residential) (Please complete each section. If a question is not applicable to Applicant, then write N/A )

Application for Water Service (Residential) (Please complete each section. If a question is not applicable to Applicant, then write N/A ) Application for Water Service (Residential) (Please complete each section. If a question is not applicable to Applicant, then write N/A ) A. Applicant Information Account Number: Service Location Address:

More information

Minor Waiver (Paper and Electronic) HFAC Water Activities Version 5/14

Minor Waiver (Paper and Electronic) HFAC Water Activities Version 5/14 MINORS UNDER THE AGE OF 18 RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT FOR HARPERS FERRY ADVENTURE CENTER INC WATER ACTIVITIES *Only the Parent or Court-Appointed Legal

More information

the USA Archery Club Agreement

the USA Archery Club Agreement USA Archery Club Membership Form Club Name: Street Address: City: State: Zip Code: Phone: ( ) Email: Club Website: Club Administrator Name: Date of Birth / / (Administrator Responsibilities: Signing Club

More information

Harris County Constable Pct 4 Explorer Post 26 and 901

Harris County Constable Pct 4 Explorer Post 26 and 901 Explorer Post 26 and 901 Explorer Application All pages must be completed in black or blue ink. All waivers must be signed to participate in the Explorer Program. Return this completed packet to the Post

More information

Minor Information. Parent/Guardian's Contact Information. Emergency Contact Information. Last Name. Phone. Address: City State Zip Code.

Minor Information. Parent/Guardian's Contact Information. Emergency Contact Information. Last Name. Phone. Address: City State Zip Code. CCCH CHILDREN'S MINISTRY 2018 VBS REGISTRATION AND LIABILITY RELEASE & MEDICAL CONSENT FORM IMPORTANT: Print, sign, and bring to the VBS Registration Table Minor Information First Name Middle Name Last

More information

RELEASE AND INDEMNIFICATFION AGREEMENTS (Minor)

RELEASE AND INDEMNIFICATFION AGREEMENTS (Minor) RELEASE AND INDEMNIFICATFION AGREEMENTS (Minor) THIS CONSENT, RELEASE, AND INDEMNIFICATION AGREEMENT ( Release ) is entered into by the undersigned in favor of Heritage Park LLC and Indian Valley Stables

More information