Registration

RLG Sports Registration/Liability Form

Please complete and submit the form to enroll your child(ren).

Registration/Liability Form

Parent/Guardian’s Name *

Parent/Guardian’s Email *

Parent/Guardian’s Phone Number *

Parent/Guardian’s Address *

Parent/Guardian’s Address

Street Address

Street Address

Apt. #

Apt. #

City

City

State/Province

State/Province

Zip/Postal

Zip/Postal

Emergency Contact’s Name *

Emergency Contact’s Phone Number *

Doctor/Physician's Name

Preferred Hospital Name

Hospital Phone Number

Child 1 Information

Please enter your child's information.

Child 1 Name *

Child 1 Age *

Child 1 Grade *

Pre K - 12

Child 1 Medical Needs/Concerns

Child 2 Information

Click to open and enter child information.

Child 3 Information

Click to open and enter child information.

Child 4 Information

Click to open and enter child information.

Child 5 Information

Click to open and enter child information.

Child 6 Information

Click to open and enter child information.

The participant(s) understands and agrees that during their time of participating in this program, R.L.G. SPORTS/MINISTRIES shall not be liable for any damages arising from personal injuries sustained in, or injuries/illness incurred on, or about the premises of the program designated area. The parent/guardian assumes full responsibility for any injuries or damage which may occur, and does hereby fully and forever release any discharge R.L.G. SPORTS, and employees, from any action or cause of action present or future whether be known or unknown, anticipated, resulting from or arising out of this program.

I agree to the above liability clause. Please sign below.

Parent/Guardian Signature *

Please sign your name using your mouse, trackpad, or you can select the keyboard icon to type it.

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