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Berkshire Thunder & Lightning Registration Form
Registration: 2025
Email *
Name of Athlete *
Address of Athlete *
Parent/Caregiver Last and First Name: Can put down more than one *
Parent/Caregiver Phone number *
Parent/Caregiver Email Address *
Emergency Contact if above can't be reached (Name & Phone Number) *
Any medical concerns or issue we need to be aware of? *
How did you hear about the Berkshire Thunder & Lightning Program *
Read the following consent & release. Choose Yes to agree to the terms. 

Medical release and consent for medical treatment

 

I, the parent/guardian of the registrant, a minor, recognize the possibility of physical injury associated with any athletic activity and in consideration of Berkshire Track Club accepting the registrant for its program, I hereby release, discharge and/or otherwise indemnify the Berkshire Track Club and any organization or person affiliated with this program including the owners of fields and facilities utilized for the activities, against any claim by or on the behalf of the registrant as a result of the registrant’s participation in this program.  I also certify that the registrant is fit to perform rigorous physical activity that may be required by the program.  I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Dentistry.


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Required

I consent to Berkshire Thunder & Lightning taking and using photographs and/or videos of my child/children in order to promote our program. These images and videos could be used in print and in digital media formats including print publications, websites, e-marketing, posters banners, advertising, film, social media, teaching and research purposes.


I understand that these images and videos may be seen on the Berkshire Thunder & Lightning website by people all over the United States.


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