AGH - Sports Program Sign Up Form
This is the signup form for the biweekly sports program run by Agincourt Gospel Hall

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Participant Name *
Participant Phone or Email Address *
Participant Age *
Emergency Contact Name *
Relationship To Participant *
Emergency Contact Phone Number *
How Did You Hear About Gym Night?
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Please list any allergies

Please read this form carefully and be aware that in signing, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which you or your minor child/ward might sustain as a result of participating in any and all activities connected with and associated with this program/activity.  

I recognize and acknowledge that there are certain risks of physical injury to participants in this program/activity, and I voluntarily agree to assume the full risk of any and all injuries, damages or loss, regardless of severity, that my minor child/ward or I may sustain as a result of said participation. I further agree to waive and relinquish all claims I or my minor child/ward may have (or accrue to me or my child/ward) as a result of participating in this program/activity against the Agincourt Gospel Hall, including its officials, agents, volunteers and employees.

I do hereby fully release and forever discharge Agincourt Gospel Hall from any and all claims for injuries, damages, or loss that my minor child/ward or I may have or which may accrue to me or my minor child/ward and arising out of, connected with, or in any way associated with this program/activity. By clicking "I agree" below, I consent that I have read and fully understand, and agree to the above important information, warning of risk, assumption of risk and waiver and release of all claims.

I also agree that I, or my minor child/ward agree to follow the rules set out by Agincourt Gospel Hall.
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