Please list any past injuries our staff should be aware of, as well as any allegries to food,medicine,etc.

Acknowlegement Statement:

I, understand that my child will be playing for Round Rock Dream Team/Texas Storm(RRDTTS). There are no refunds of fees paid. Fees due but not paid and missed practices may result in my child being replaced on the team. Fundraising is a required part of RRDT program. I have read, understand and signed the RRDT Mission Statement and agree to the time commitment required to participate in RRDT program.

RRDTTS
P O Box 2372
Austin, TX 78768-2372

Legal Disclaimer: Aparent or legal guardian must sigh this before participation will be allowed.

Round Rock Dream Team/ Texas Storm
P O Box 2372
Austin, TX 78768-2372

I, hereby release sponsors, RRDTTS, its officers,coaches, employees, and all facility owners/operators of damages or injuries incurred while my child participates in RRDT activities. I certify that my child is in good health and can participate in all physical activities. Should an injury occur, I agree to allow my child to be treated by a licensed phyiscian or paramedic.

Parents/Guardian Signature:_______________________

__________________________________________________

Date Signed:______________________________________