UVC Summer Program Registration
TOLAR & Mineral Wells
Email address *
T-shirt size of Participant *
Child Name (first and last) *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Address *
Your answer
Phone Number *
Your answer
Parent or Legal Guardian Contact Name (first and last) *
Your answer
Parent or Legal Guardian Contact Number *
Your answer
Can we text? *
Parent or Legal Guardian Email *
Your answer
Allergies and/or Medical Conditions *
Your answer
Food Allergies? *
Your answer
Grade *
Siblings playing in league (first/last name & grade)*EACH CHILD MUST REGISTER* *
Your answer
Participants agree to assume all risks and responsibility for any and all claims for damages, including personal injury or death, medical expenses, disability, lost wages, loss of earnings, capacity and property damages which may incurred by Participant while Participant engages in athletic games, events, practice sessions, conditioning sessions and travel if any. (type I agree below and date) *
Your answer
Parent Digital Signature *
Your answer
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