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Athletics Registration Form

ACTIVITY


PARTICIPANT INFORMATION

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PARENT/GUARDIAN INFORMATION


VOLUNTEER INFORMATION

 

TEAM SPONSORSHIP

If you are interested in sponsoring a team, complete the following:

MEDICAL INSURANCE

 

EMERGENCY

If you wish for your family doctor to be contacted in case of emergency, please list name and phone number.

WAIVER/DISCLAIMER

In consideration of the acceptance of my child's entry, I hereby, for myself, my child, my heirs, executor and administrators, waive and release any and all rights and claims for damages I or my child may have against the North Charleston Recreation Department and its representatives, successors, and assigns for any and all injuries suffered by myself or my child at any activity sponsored by this group. I understand that the risk to my/our child includes a full range of injuries, from minor to severe, and that the result could be death, paralysis, or other serious permanent disability and that I am encouraged to maintain proper insurance coverage for my child during the duration of his/her participation in specified activities with this Department. The North Charleston Recreation Department encourages parent's to have physical examinations done on their children prior to participation in any athletic programs. The pre-existing conditions with regard to the health of children are very important for parents to be aware of prior to participation in strenuous athletic events. I do hereby grant permission to the City of North Charleston Recreation Department the use of photographs of my child in advertisements, publications and or any other collateral materials. I also acknowledge that any request given by me to the Recreation Department is accepted only as a request. I do hereby certify all of the above information to be correct and true.
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* Indicates Response Required
P.O. Box 190016, North Charleston, SC 29419