OLG Online Registration
|
! Indicates required information
|
| ! Choose a Sport: |
|
|
PLAYER INFORMATION
|
| ! First Name: |
|
| ! Last Name: |
|
| ! Address: |
|
| ! City: |
|
| ! State: |
|
| ! Zip Code: |
|
| ! Home Phone: |
|
| ! Birthdate: |
|
| ! Gender: |
|
| ! School: |
|
| ! Grade: |
|
| ! How did you find out about this Registration?: |
|
|
|
|
PARENT(s)/GUARDIAN(s)
|
| ! First Name: |
|
| ! Last Name: |
|
| Work Phone: |
|
| ! Emergency Number: |
|
| ! Primary E-Mail address: |
|
| 2nd E-Mail address (optional): |
|
| |
Are you interested in coaching?
|
|
| 2nd Parent First Name: |
|
| 2nd Parent Last Name: |
|
| 2nd Parent Emergency Phone: |
|
| |
Are you interested in coaching?
|
|
|
|
MEDICAL INFORMATION
|
Special Medical Conditions or Instructions (Explain condition or type 'none') !
|
|
|
|
REGISTRATION/UNIFORM FEES
|
Reg Fee for Basketball $125.00 ($175.00 per Family)
Make Checks payable to "OUR LADY OF GUADALUPE"
Give checks to the Head coach of the team
|
|
|
|
APPROVAL TO PARTICIPATE AND LIABILITY RELEASE
|
|
I/We as parents or guardians of the above named child hereby give my approval for his/her participation in any and all of the activities of this program during the current season. I/We do further hereby release, absolve, and hold harmless the Youth Ministry of Our Lady of Guadalupe, the organizers, sponsors, supervisors, coaches and drivers of any the organizations and programs in case of injury to my son or daughter. I/we hereby waive all claims against the organizers, sponsors, supervisors, coaches, and drivers or anyone appointed by them. I/We assume all responsibility for the entire medical payments not covered by Youth Ministry insurance.
|
| |
I/we agree with the above !
|
|
|
|
PARISH ELIGIBILITY REQUIREMENTS
|
|
I/we agree that the child named above is a registered parishoner of Our Lady of Guadalupe parish and is attending either Catholic school, A parish PREP program or has been confirmed.
|
| |
I/we agree with the above !
|
|
! Indicates required information
|
|
