Assessment Week Registration Form
Hello Parents,
We are excited about the year we are having in 2020 as a program, but we are always looking to improve! Our teams have made some serious strides, and we look forward towards continuing our progress in 2021! Assessment Week will take place for all current and potential players from 10/20-10/22.

*Tuesday, 10/20: 12-14U or Grades 7-9 at Croydon Hall from 3:30-4:30pm.
*Wednesday, 10/21: 10-11U or Grades 5-6 at Dorsett Park from 4-5pm.
*Thursday, 10/22: 8-9U or Grades 3-4 at Dorsett Park from 4-5pm.

All current and potential players must fill out form to participate in tryout.
Sincerely,
Coach Ryan Spillane
Twitter @MiddEagles
Email address *
LAST NAME, FIRST NAME *
Which tryout will your son attend? (If he cannot attend the one for his age group please choose one of the other two and note it in the next question. If he cannot attend either please select last option.) *
My son is NOT going to be at the tryout for his particular age group due to a previous commitment, but WILL attend one of the two alternative dates selected in previous question.
Clear selection
My son cannot attend any of the 3 assessment dates and I will need an alternative.
Clear selection
CURRENT AGE *
GRADE *
DATE OF BIRTH *
MM
/
DD
/
YYYY
If your son has any conflicts due to other commitments for the upcoming year please explain. *
What school does your son attend? *
Phone Number *
Hold Harmless Agreement/Player Waiver: In consideration of being allowed to participate in the event or activity referenced above, I acknowledge, appreciate, and agree that: 1) The risk of injury/illness from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury/illness does exist; and, 2) The risk to have contact with individuals, who have been exposed to and/or have been diagnosed with one or more communicable diseases, including but not limited to COVID-19 or other medical conditions, diseases, or maladies does exist, and it is impossible to eliminate the risk that I could be exposed to and/or become infected through contact with or close proximity with an individual with a communicable disease. 3) I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, 4) I willingly agree to comply with the stated and customary terms and conditions for participation including those requirements set forth in the NJDOH guidelines which are appended to this waiver and incorporated herein by reference. Consistent with these guidelines I acknowledge that Releasor's temperature will be taken prior to each session. The Releasor acknowledges that if the participant's body temperature is above that recommended by the NJDOH guideline, the participant may not take part in the session. Moreover, if the participant demonstrates any sign of illness prior to a practice or game, the participant may not take part. If within 14 days prior to the start of the season or anytime during the season, the participant has been exposed to anyone who has tested positive for or suspected to have contracted COVID-19, the participant may not take part in practice or games until a negative test result is documented and the player quarantines for 14 days. If, however, I, observe any unusual significant hazard during my son's presence or participation, I will remove him from participation and bring such to the attention of the nearest official immediately; and, 5) I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS the Releasees, their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event ("RELEASEES"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.6) I have read and understand the NJDOH guidelines and agree to comply with all State and Local guidelines.I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. *
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy