2023 K-2 INSTRUCTIONAL LEAGUE LATE REGISTRATION

Participant Information

First Name *

Last Name *

Gender *

Male

Female

Birthdate *

School *

Child's Grade *

Tee Shirt Size *

League and Team Information

Indicate the league you are signing your child up for ($250 per participant) *

Co-ed Kindergarten - Registration

1st Grade Boys - Registration

1st Grade Girls - Registration

2nd Grade Boys- Registration

2nd Grade Girls - Registration

Team name, if part of a team

Coaches name if part of a team

Parent Information

First Name *

Last Name *

Email Address *

Street Address *

City *

State *

Zip Code *

Cell Phone Number *

Are you or another relative interested in becoming a volunteer coach? *

Yes

No

Please list the coaches name, if applicable

How did you here about us? *

If you heard of us through a friend, please list their name below, so we may thank them

Emergency Information

First Name *

Last Name *

Cell Phone Number *

Additional Information

I consent to my child being used in any photographs to be used in advertising or promotion of FFA.

Agree

Disagree

In the event of an emergency I agree to accept any and all determinations of need for medical assistance and/or administration of medical attention deemed necessary by staff of Fundamentals Firts Academy. I understand that Fundamentals First Academy and its' affiliates do not employ trained medical personnel. I hereby give permission to Fundamentals First Academy, its' employees, agents, and/or others to secure any and all medical, hospitalization, dental, and/or surgical treatment it deems necessary. In the event that such medical attention is needed from a health care provider, all costs shall be the responsibility of the parent or guardian. Fundamentals First Academy provides a secondary coverage for its participants. *

Agree

By checking the box below you agree that the participant listed has his or her own health insurance. *

Agree

By checking this box you are aware that the staff of FFA reserves the right to dismiss any participant whose conduct is detrimental to affording the group the proper respect and instructional learning environment as deemed by FFA staff. *

Agree

As consideration for being permitted by Fundamentals First Academy or any affiliated organizations to participate in these activities and/or use of their facilities, I hereby agree that I/WE, my assignees, agents, heirs, guardians, guests, relatives, and legal representatives shall not make a claim against, sue or attack Fundamentals First Academy, or any of its affiliated organizations, or any members or individuals of the organizations, for injury or damage resulting from negligence or other acts, howsoever caused, by any employee, agents or contractor of Fundamentals First Academy or any affiliated organization as a result of any participation in the various activities within Fundamentals First Academy. *

Agree

I have read and thus agree to the FUNDAMENTALS FIRST ACADEMY CORONA VIRUS WAIVER AND ASSUMPTION OF RISK, RELEASE WAIVER OF LIABILITY AND INDEMNITY AGREEMENT *

Agree