"VOLLEY FOR LIFE" Volleyball & Cornhole Youth Registration

PARENTAL/GUARDIAN CONSENT FORM AND LIABILITY WAIVER

FOR YOUTH 17 & UNDER

First 8 teams to register guaranteed play- may expand tournament depending on number of teams wanting to play.

Tournament is Co-Ed

Teams must have at least 6 players.
There must be at least two girls/women on the court at all times.

Rules will be posted online.

Teams and Players will be contacted with game times once all Registrations are in and processed.

Participant's Name: Participant's Name: * First Last
Date of Birth: Date of Birth: * / MM / DD YYYY
Parent/Guardian's Name: Parent/Guardian's Name: * First Last
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Parent Cell: Parent Cell: * - ### - ### ####
Parent Email *
Participant Email: *
Volleyball Player
Division
If registering for a Team state Team Name.

If playing on two teams list all Team Names. At checkout, pay for two registrations.

If playing on two teams, teams must be in separate divisions.
There is no guarantee that your teams will not be scheduled at the same time. You would have to choose between teams.

For example: Team "Smith Family"

If playing for more than one Team, list all Teams
Cornhole Player
If registering for a Team or Teams, list Team Name.

2 Players per Team

For example: Team "Smith Family"
If playing for more than one team, list all teams
I, Parent/Guardian I, Parent/Guardian * First Last
grant permission for my child
Participant's name: Participant's name: * First Last
to participate in this parish activity that may require transportation to a location away from the parish site. If so, transportation is on own. This activity will take place under the guidance and direction of parish employees and/or volunteers from St. Peter Parish Covington, La.
A brief description of the activity follows:

Type of event: Volleyball Tournament &/or Cornhole Tournament

Date: November 23, 2019

Time: 10-6pm
As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named minor (“participant”).

I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend St Peter Parish Covington,La. its officers, directors and agents, and the New Orleans Archdiocese, coaches, chaperones, or representatives associated with the event, arising from or in connection with my child attending the event or in connection with any illness or injury or cost of medical treatment in connection therewith, and I agree to compensate the parish, its officers, directors and agents, and the New Orleans Archdiocese, coaches, chaperones, or representatives associated with the activity for reasonable attorney’s fees and expenses arising in connection therewith.
*

Check here to indicate that you have read and agree to the terms stated above.
Parent/Guardian Signature: *

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Today's Date: Today's Date: * / MM / DD YYYY
NOTE:
If you are a registered member of St. Peter CYO, ROCK, or Confirmation you do not need to fill out the following Medical Information.

Medical Matters :
I hereby warrant that to the best of my knowledge, my child is in
good health, and I assume all responsibility for the health of my child. (Of the following
statements pertaining to medical matters, sign only those that are applicable.)

Emergency Medical Treatment: In the event of an emergency, I hereby give permission to transport my child to a hospital for emergency medical or surgical treatment.

I wish to be advised prior to any further treatment by the hospital or doctor.
In the event of an emergency, if you are unable to reach me at the above numbers, contact:
Emergency Contact Emergency Contact First Last
Relationship
Phone Phone - ### - ### ####
Family Doctor Family Doctor First Last
Phone Phone - ### - ### ####
Family Health Plan & Policy#

If no plan state NONE
Allergies:

If no state NONE
Physical Limitations:

If no state NONE
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date / MM / DD YYYY
FEES:

Volleyball Registration Fee - $15 per player per team

Cornhole Registration Fee - $5 per player per team
You must Submit form to complete registration.

You will then be redirected to another site for Fee payment options, including payment by cash/check.

"VOLLEY FOR LIFE" Volleyball & Cornhole Youth Registration

"VOLLEY FOR LIFE" Volleyball & Cornhole Youth Registration

grant permission for my child

to participate in this parish activity that may require transportation to a location away from the parish site. If so, transportation is on own. This activity will take place under the guidance and direction of parish employees and/or volunteers from St. Peter Parish Covington, La.

A brief description of the activity follows: Type of event: Volleyball Tournament &/or Cornhole Tournament Date: November 23, 2019 Time: 10-6pm

FEES: Volleyball Registration Fee - $15 per player per team Cornhole Registration Fee - $5 per player per team

You must Submit form to complete registration. You will then be redirected to another site for Fee payment options, including payment by cash/check.

A brief description of the activity follows:

Type of event: Volleyball Tournament &/or Cornhole Tournament

Date: November 23, 2019

Time: 10-6pm

FEES:

Volleyball Registration Fee - $15 per player per team

Cornhole Registration Fee - $5 per player per team

You must Submit form to complete registration.

You will then be redirected to another site for Fee payment options, including payment by cash/check.