IceBourg Athletics - Weekly Class Registration

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Athletes First & Last Name *

Athletes Age *

Parent/ Guardian Name *

Parent/ Guardian Phone Number *

Parent/ Guardian Email *

Class You are Registering For *

Friday, October 2 - 6pm

Does you athlete have any injuries, medical conditions, allergies, or physical limitations we should be aware of?

Emergency Contact Name & Number *

PARTICIPATION WAIVER & RELEASE

I understand that participation in IceBourg Athletics activities, including running, jumping, agility drills, strength and conditioning exercises, games, and other physical activities, involves inherent risks of injury. I voluntarily give permission for my child to participate and acknowledge and accept these risks.

I certify that my child is physically able to participate and that I have disclosed any known medical conditions, injuries, allergies, or physical limitations that may affect participation.

In consideration of my child being permitted to participate, I agree to release and hold harmless IceBourg Athletics, its owners, coaches, volunteers, staff, and facility from claims arising from the ordinary risks associated with participation, to the extent permitted by law.

In the event of an emergency, I authorize IceBourg Athletics staff to contact emergency services and the emergency contact provided if I cannot be reached.

Parent/ Guardian Waiver & Consent *

I have read and agree to the IceBourg Athletics participation waiver and give permission for my athlete to participate.

Required

Photo & Video Permission *

Yes — I give permission for photos/videos of my athlete to be used by IceBourg Athletics for social media, website, and promotional purposes.

No — I do not give permission.

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