Sign Your Child Up to Participate
FREE
The classes are free if your child is a foster child or receives free or reduced cost meals at school, or your family is below the 133% line in the federal guidelines table here. You will need to bring documentation of the free/reduced lunch status or your most recent 1040 tax return to the first class.
REDUCED
If your family income is at the 200% level or below in the federal guidelines table here, you are eligible for a 50% discount. The cost is $7.50 per session or $48 for all eight (8) sessions. You will need to bring your most recent 1040 tax return and your payment to the first class.
FULL
The cost is $15 per session or $96 for all eight (8) sessions. You will need to bring your payment to the first class. You will also need to bring the liability release form to the first class here.
Request a Tutor or Mentor
TUTOR REQUEST FORM
REGISTER A CHILD FORM
LIABILITY RELEASE FORM
Participant’s Name ____________________________
Parent’s/Legal Guardian's Name ____________________________
Phone Number _______________________
PLEASE READ CAREFULLY
Does this child have any disabilities, handicaps, present injuries or limitations, allergies, hemophilia, heart condition, history of respiratory illness, or any other significant medical condition?
(CIRCLE ONE) YES NO
If yes, please state condition:
Would you like to have a doctor contacted in case of emergency? (CIRCLE ONE) YES NO
Doctor’s Name/Phone:
EMERGENCY AUTHORIZATION
I, the undersigned parent or legal guardian of ____________________________, a minor, hereby authorize the coaches, assistant coaches or parents of team members acting in the capacity of activity supervisors/vehicle drivers as my Agents to consent to medical, surgical or dental examination and/or treatment. In case of emergency, I hereby authorize treatment and/or care at any hospital. If there is an emergency and I cannot be reached please contact the above emergency contact.
__________________________________________________
Signature of Parent/Legal Guardian of minor under age 18
_______________________
Date
WAIVER OF LIABILITY, DISCLAIMER, AND PERMISSION
I, the parent or legal guardian of ________________________________, acknowledge that participation in athletic events involves risk of physical injury. In consideration for accepting the registration of the named individual and permitting the voluntary participation of said individual in its programs, I hereby release, discharge, and hold harmless SportsWorks, it’s employees, volunteers and other representatives from any claims arising out of, or relating to any physical injury that may result to _____________________________________________ while participating in a SportsWorks sponsored event, including any physical injury by the negligence of any official, referee, or coach while performing his/her duties during any practices or games.
__________________________________________________
Signature of Parent/Legal Guardian of minor under age 18
_______________________
Date
sportsworks_liability_release_form.pdf | |
File Size: | 129 kb |
File Type: |