NBN

YOUTH LEAGUE REGISTRATION

Each Player will be assessed and selected for there perspective teams. Practice will be once a week and game days will be on the weekend. 6+ games and playoffs will be played.

PLAYER INFORMATION

* First Name:

* Last Name:

Street:

City:

State:

Zip Code:

* Home Phone:

* Birthdate:

* Email:

* Gender:

* Grade:

ADDITIONAL PLAYER INFORMATION

First Name:

Last Name:

Birthdate:

Email:

Gender:

Grade:

PARENT/GUARDIAN #1

Firstname:

Lastname:

EMail:

Home Phone:

Work Phone:

Cell Phone:

PARENT/GUARDIAN #2

Firstname:

Lastname:

Email:

Home Phone:

Cell Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

Emergency Contact:

Phone:

Relationship to Player:

Insurance Carrier:

Policy #:

WAIVER INFORMATION

Medical Consent

I, THE PARTICIPANT, ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES ASSOCIATED WITH THIS OCCURANCE, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault.
I certify that Participant is physically fit, have sufficiently prepared for participation in this activity, and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in this activity.

I/we agree with the above *

Photography Consent

In consideration of participation in the NBN Youth League, the undersigned agrees that their likeness may be photographed or videotaped, that such image may be published in an outlet used to promote or publicize the program and that names may be used unless otherwise specified by the undersigned.

I/we agree with the above *

Covid Waiver

Please understand that despite all the precautions that you, other members, and/or COMPANY may take, we cannot guarantee your health or safety, and you may still be exposed to COVID-19, including through interactions with other individuals who have COVID-19. By executing this release and gaining access to the facility, you, on behalf of yourself, your heirs, beneficiaries, representatives, successors and assigns: (1) voluntarily assume all risks associated with any exposure to COVID-19, including, but not limited to suffering any type of medical condition, illness and, potentially, death; and (2) knowingly and voluntarily waive, release, covenant not to sue, forever discharge, indemnify, and hold harmless COMPANY, its parents and subsidiaries and their respective officers, directors, employees, contractors, agents, representatives, successors and assigns (?Released Parties?) from any and all liability, damages, losses, suits, demands, causes of action to the fullest extent permitted by the laws of this state, or any other claims of any nature whatsoever, arising out of or relating in any way to your use of the facility and your potential exposure to COVID-19.

I/we agree with the above *

Parent Waiver

I the parent or guardian of a NBN sports team player, agree that the most important outcome of any game is for my child to have fun. My child needs my approval and support, regardless of what happens in the game. I will refrain from the use of negative or derogatory language aimed at the Officials, the Coaches, NBN staff, my child, or other players. I will encourage my child and all others in the game and will let the coach be the coach. I will do my best to model the sportsmanship-like behavior I wish my child to adopt, and to support the coach in making his the best possible experience for my child.?

I/we agree with the above *

Once form is completed, whether you are paying online or in-person select your amount due and hit the "submit form" button. You must submit the form in order to complete registration, payment DOES NOT have to be done online.

Signature:

Date:

* indicates required fields

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YOUTH LEAGUE REGISTRATION