Player Information

Player Name *

Player Birthday *

T-shirt Size (please indicate if youth size)

Parent / Guardian Information

Parent or Guardian Name *

Parent or Guardian Phone Number *

Email Address *

Address 1 *

Address 2

City *

State *

ZIP Code *

Emergency Contact

Emergency Contact Name *

Emergency Contact Phone *

Waiver and Agreements

Waiver and Hold Harmless Agreement

• Please read this form carefully and be aware that by having your child registered and participating in this program, you will be waiving and releasing all claims for injuries your child might sustain in this program.

• While we strive to provide a safe environment, we cannot control what your child will come in contact with because of the open environment on a college campus.

• As the parent/legal guardian of a participant in this program, you recognize and acknowledge that there are certain risks of physical injury and agree to assume full risk of any injury, damage or loss.

• You agree to waive, release, discharge all claims against MYAA, its Board, officers, representatives, agents, and employees.

• You further agree to indemnify, hold harmless, and defend MYAA from any and all claims resulting from injuries, damages, and losses sustained by your child.

• In the event of an emergency, if MYAA cannot contact the emergency contact(s), you authorize staff to secure medical treatment and agree to be responsible for payment.

I have read and agree to the Waiver and Hold Harmless Agreement.

Media Release

As a parent/legal guardian of a participant, you authorize and acknowledge permission for your child’s image to be used by MYAA for official purposes.

I acknowledge and grant permission for media release.

Sports Camps Behavioral Guidelines

By submitting this registration, I confirm I have read, understand, and my child and I will adhere to the safety, program, and behavioral guidelines.

• Behave in a friendly, cooperative, and responsible manner towards other students, instructors, and staff;

• Respect the ideas and property of others;

• Participate and be actively engaged during sessions.

Students may be excluded from activities or dismissed for:

• Leaving assigned area unaccompanied by staff;

• Stealing or vandalizing property;

• Bullying;

• Jeopardizing safety of self or others;

• Disrupting the learning environment.

MYAA reserves the right to exclude or remove any student not adhering to these guidelines.

I agree to the behavioral guidelines.

Guardian Confirmation

Parent or Guardian Name *

Payment Method

Select Payment Method *
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