HTML Preview Youth Sports Registration Sheet page number 1.
YOUTH SPORTS REGISTRATION FORM
Dear Parent or Guardian:
The Seattle Department of Parks and Recreation welcomes your child to our Youth Sports Program. We hope that your child will find the
experience rewarding and will develop skills and friendships that he or she will keep for the rest of his/her life.
Your child will be placed on a team based on an assessment by Recreation staff and/or volunteer coaches using the following criteria: safety,
skills, and ability. If there are only enough youth to form one team in your child's age division and gender at the desired community center,
your child will automatically be placed on that team. The ability of the team is then assessed by Recreation staff and the team is placed for
example in the appropriate league, either Gold (competitive), Silver and Bronze (recreational) or House League (recreational skill
development).
If there are not enough participants to form a team with your child's age and/or gender classification at the community center where you
signed up, you will be given the opportunity to have your child join a team at another community center, join a team in a different age group,
or join a team of the opposite gender if there is space available.
As a condition of your child's participation in this activity, you must complete and sign the attached form and return it to the community center
where your child is participating. If you do not want to authorize the City to secure medical treatment for your child in the event of an accident
and you cannot be contacted, then cross out and initial the medical authorization paragraph. Be sure, nonetheless, to complete the
"Emergency and Medical Information" section. Thank you.
Community Center
Child's Name Parent's Name_______________________________________
Age Birthdate Sex Home Phone Parent's Work
Parent Cell Phone Parent’s email
Address ____ City _____ Zip ________________
School ___Grade __ ______
Uniform Size: YS___YM___YL___AS___AM____AL___AXL__ AXXL
Coach or player request: *Please Note: No guarantee can be made for coach , team or player request
Sport or Activity Signature of Parent or Guardian Date
**************************************************************************************************************************************************************
This form has four sections (1) an assumption of risk and release; (2) paragraph of instruction; (3) medical authorization; and (4) a participant
information form. The first section tells you about risks of injury that may arise from participating in a sport or activity of the Department's
Youth Sports Program in order to aid you in making an informed decision as to whether or not your child should participate in this athletic
activity and requires you to assume its risks. The second section emphasizes obedience to safety rules. The third section gives the
Department authorization to provide medical care in case an accident should happen and you cannot be contacted. The fourth section
provides the Department important information about your child.
As a parent or guardian, you should ask coaches, physicians, and other knowledgeable persons about any concerns that you might have at
any time about your child's participation or safety. The decision for your child to participate is yours.
I. ASSUMPTION OF RISKS
Injuries to participants in the Youth Sports Program may occur from risks inherent in the sports or activity; from placing stress on the body
that has not been prepared for; from accidents in learning or practicing playing techniques; from failing to follow game, training, safety or
other team rules; from the use of transportation to and from games and other events; and from administration of first aid. Injury can include
direct physical, and possibly crippling, injury to one's body, and emotional injury experienced as a result of inflicting injury to another or
witnessing it. The severity of injury can range from minor cuts, scrapes, or muscle strain to catastrophic injury, such as paralysis or even
death.
In consideration of the City and the Seattle Department of Parks and Recreation permitting my child or ward to participate in its Youth Sports
Program, I hereby agree on behalf of my child that he or she will assume the risk of injury or death from participating as outlined above. I
release the City, its Department of Parks and Recreation, the Department's employees, advisory councils, and/or volunteers from any liability
resulting from my child's participating in the sport or activity. This assumption of risk and release binds by child's heirs, estate, executor or
administrator, and assigns all members of my family.
u:\referenc\forms\e02.doc & INWEB E2 E-2 (9/09)