2021 Summer Program
AMATA Sports Summer Program
Athlete Name (first & last name)
Training only (3x/week for 3 months $150)
Training and Competitions (3 months $300)
Address (street, city, state, zip)
Primary Phone Number (xxx) xxx-xxxx
School Name (if applicable)
Grade (2020-21 Academic Year)
Middle School (6th-8th Grade)
9th Grade (Freshman)
10th Grade (Sophomore)
11th Grade (Junior)
12th Grade (Senior)
Date of Birth (mm/dd/yyyy)
T-Shirt Size (Unisex)
I, the athlete or undersigned parent/guardian of above athlete, agree to assume full responsibility for any risks, injuries or damages, known or unknown, which might incur as result to participating in the program. I am participating in the 2019 AMATA Track & Field Program during which I will receive information, instruction and hands on application for events related to athletics. I recognize that this program requires physical exertion that may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in the 2019 AMATA Summer Program. I represent and warrant that I am physically fit and have no medical condition that would prevent my full participation in the 2019 AMATA Summer Program. I knowingly, voluntarily and expressly waive any claim I may have against AMATA or any representative thereof, for injury or damages that I may sustain as a result from participating in the program. I, my heirs, or legal representatives forever release, waive discharge and covenant not to sue AMATA Sports, Lutheran High School, or any representative thereof, for any injury or death caused by negligence or other acts. I have read the release and waiver of liability and fully understand its contents and agree to the terms and conditions as stated.
A copy of your responses will be emailed to the address you provided.
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