Event Registration and Athletic Activity Release and Waiver of Liability Form

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Event Registration Form

Event Name/Details:

Participant's First Name:

Participant's Last Name:

Participant's Birthday:

Today's Date:

Participant's Current Age:

Graduation Year:

Participant's Email:

Participant's Phone Number:

Emergency Contact Name:

Emergency Contact Number:

Emergency Contact Relationship:

Most Resent Physical Date:

(Must be within last 12 months)

Upload a copy of recent physical:

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What school are you currently attending and what town is it located?

What position do you currently play?

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