Team Enduro Lab

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Team Enduro Lab

Registration and Liability Release: Team Enduro Lab presented by Bicycle Heaven

Email *

ATHLETE

This first section is primarily about the ATHLETE.

Athlete - first and last name *

Athlete - cell phone number *

Athlete - email address (not school email address) *

Athlete - gender *

Female

Male

Prefer not to say

Other:

Athlete - date of birth *

YYYY

Athlete - grade for fall 2022/spring 2023 *

Athlete - in good physical and mental health? *

Yes

Other:

Athlete - list any allergies or "none" if none. *

Athlete - list any medical conditions and any details as appropriate or "none" if none. *

Athlete - uses an asthma inhaler? *

Yes

Athlete - list any medications taken regularly or "none" if none. *

Authorize Team Enduro Lab coaches to give ibuprofen, if needed? *

Yes

PARENT/GUARDIAN

PRIMARY Parent/Guardian - first and last name. This is the first emergency contact. *

PRIMARY Parent/Guardian - cell phone number *

PRIMARY Parent/Guardian - email address *

Address - number, street name, city, state, zip *

Secondary Parent/Guardian - first and name. This is the second emergency contact. *

Secondary Parent/Guardian - cell phone number *

Secondary Parent/Guardian - email address *

Emergency Contact - 3 (name and cell phone) *

Emergency Contact - 4 (name and cell phone) *

PRIMARY Parent/Guardian - Please review and agree to the Liability Release Agreement. This is REQUIRED in order to ride, practice, and/or race with Team Enduro Lab. https://docs.google.com/document/d/1qH-YcZpPIZciWhTqhDHW2bcxRxSfGdXD_YQkS2_6VhY/edit?usp=sharing *

Yes, I acknowledge that I have read, understand, and fully agree to the provisions of the Liability Release Agreement.

PRIMARY Parent/Guardian - Permission to use media and photos: I give my permission for Team Enduro Lab presented by Bicycle Heaven, its sponsors and outside media agents (newspapers, television, etc.) to take photographs, video, and otherwise document my child involved in the activities of this program. I give permission for any photographs or video material of my child to be used in publicity about the program and organization (website, promotional materials, newspaper/magazine articles, etc.). *

Yes

Thank you for registering your athlete! Please leave any additional comments here you'd like us to know about your athlete.

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