Texas Elite Segovia 18U

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Tryout Form 18U

* First Name:

* Last Name:

Street:

City:

Phone Number:

Email:

Birthdate:

Grade:

* Age group trying out for ::

* Experience playing select:

* What team did you last play for:

* What positions do you play:

* Do you have a private coach:

* What do you take lessons for:

* Coaches name and number:

Parent/Guardian #1

First Name:

Last Name:

Cell Number:

* Email:

Phone Number:

Parent/Guardian #2

* First Name:

* Last Name:

Cell Number:

* Email:

Medical/Emergency contact information

* Emergency Contact:

* Phone Number:

Relationship to player:

Insurance Carrier:

Policy Number:

WAIVER INFORMATION
I give my permission for my child to try out for the Texas Elite Segovia travel team. I hereby consent to my child's participation in any activities of the Texas Elite Segovia team, and I agree to release, indemnify, and hold harmles Texas Elite Segovia team and its officers, directors, coaches and agents from and against any liability of any kind arising out of the activities of Texas Elite Segovia. I understand that I am responsible for providing medical insurance for my child.

The undersigned, the parent(s) or legal guardian(s) of the above-named minor, hereby authorize my child’s coach or any other official of Texas Elite Segovia to consent to any medical examination or treatment, including hospitalization and/or surgery, which is deemed advisable, appropriate or necessary by any duly licensed physician, emergency medical technician, paramedic or other medical practitioner in order to properly care for my child in the event she sustains injury or is suffering from any illness during the course of any playing or non-playing activities of Texas Elite Segovia provided, however, the foregoing consent or authorization shall be valid only in a situation where a parent or legal guardian of the above-mentioned minor is not reasonably available to provide the necessary consent to medical treatment.

I understand that participation in competitive athletics involves risk of physical injury or death which cannot be totally eliminated. However, players may reduce such risk by following a proper conditioning program, wearing or using helmets and other appropriate safety equipment, and properly reporting any injury to their coaches. In allowing my child to participate in the activities of Texas Elite Segovia, I understand that we are expressly assuming the risks referred to above and releasing Texas Elite Segovia, its officers, directors, coaches and agents form and against any liability of any kind arising out of the activities of the the Texas Elite Segovia from any and all liability arising out of or in any related to the activities giving rise to such risks.

I understand that player fees must be paid by specified date(s) if a roster spot is offered to and accepted by Player and Parents/Guardians. I also understand that NO REFUNDS of fees will be made once a roster spot is offered to and accepted by Player and Parents/Guardians.

Thanks for your interest in Texas Elite Segovia!!

I / We agree with the above *

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Tryout Form 18U