New Youth Member Application
Youth GMN SAL Membership Application
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Email *
Main Branch of Attendance *
Participant Name *
First and Last name
Date of Birth
MM
/
DD
/
YYYY
Participant Gender
Clear selection
Participant School (i.e Cambridge High, Caldwell High, etc.)
4 digit pin for participant sign in  *
Name (Legal Guardian) *
Phone number *
Address( City, State, Zip)
Emergency Contact Name *
Emergency Contact Relationship to Participant
Emergency Contact Number *
Allergies, Medical conditions, Physical Limitations, ect.
CONSENT FOR PARTICIPATION: "I hereby consent to the above listed child's Participation in the Guernsey Monroe and Noble Sheriff Activities and Athletic League's programs and events. The participants' use of the GMN SAL's facilities and equipment, and the participation in any GMN SAL Program, including any Transportation provided by the GMN SAL, shall be undertaken at the sole risk of the undersigned guardian. The GMN SAL and its staff shall not be liable for any damages, harm, or injuries, of any kind, nature or description to the participant. The GMN SAL will not be subject to any action, claim, demand or suit whatsoever for injury or Damages, including, without limitations, those resulting from any GMN SAL program or special event. As the legal guardian of the child listed above , I agree to assume all responsibility in the event of personal injury or property damage while the child is Participating in any and all programs and events" *
VIDEO-PHOTO RELEASE I understand that during The Guernsey Monroe Noble County Sheriff Activities and Athletic Leagues (GMN SAL) program and/or activity, my photograph and/or the photograph of my child may be taken by; the GMN SAL, producers, sponsors, organizer, and/or assigns. I agree that my photograph and/ or the photograph of my child including video photography, film photography, or the GMN SAL volunteers, sponsors, organizers may use other reproduction of my likeness or the likeness of my child, without charge and/or its assigns for such purposed, as they deem appropriate. *
RACE:   Check all that apply (optional for grant purposes only)
Other Race:
By printing your name here, you agree to all above terms and conditions, and any changes to your athletes file, you will contact any staff within GMN SAL.

Electronic Signatures. Each party agrees that this membership application and any other documents to be delivered in connection herewith may be electronically signed, and that any electronic signatures appearing on this Agreement or such other documents are the same as handwritten signatures for the purposes of validity, enforceability, and admissibility.
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A copy of your responses will be emailed to the address you provided.
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