IMAGINE WEST GILBERT ATHLETICS
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Registration Form
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NFHS Concussion in Sports
Printable Forms
Home
Information
Athletic Booster Commitee
Contact Us
Schedule
Volleyball
Football
Girls Basketball
Boys Basketball
Cheer
Registration Form
Athletic Handbook
Athletic Contract
NFHS Concussion in Sports
Printable Forms
2015-2016
Student Athlete Registration
Student-Athlete Name
*
First
Last
DOB
*
Grade
*
Teacher
*
Student Email
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Parent / Guardian 1 Name
*
First
Last
Parent / Guardian 1 Email
*
Parent / Guardian 1 Phone Number
*
-
-
Parent / Guardian 2 Name
*
First
Last
Parent / Guardian 2 Email
*
Parent / Guardian 2 Phone Number
*
-
-
RELEASE, INDEMNITY, AND ASSUMPTION OF RISK
I/We give our permission for my child, (student athlete typed name above), to participate in organized interscholastic athletics, realizing that such activity involves the potential for injury, which is inherent in all sports. I/We acknowledge that even with the best coaching, use of the most advanced protective equipment and strict observance of rules, injuries are still a possibility. On rare occasions, the injuries can be so severe as to result in total disability, paralysis, quadriplegia or even death. To the extent permitted by law, we agree to release, hold harmless and indemnify the State of Arizona, Imagine Schools West Gilbert, Arizona Charter (Canyon) Athletic Association and their regents, officers, employees, agents, and assigns from and against any present or future claim, loss or liability for injury to person which our child may suffer or for which our child may be liable to any other person during his/her participation. I/We acknowledge that I/we have read and understand this release.
Choose One
*
* I certify that I am the legal parent/guardian of the student-athlete who's name appears on this form and I acknowledge that I have read and understand the release.
Parent Signature (Type Full Name)
*
Submit