REGISTER

Parent/Guardian's Name *
Parent/Guardian's Name
Parent/Guardian's Phone *
Parent/Guardian's Phone
Child #1
Child's Name *
Child's Name
Child's Date of Birth *
Child's Date of Birth
Please note that groups will be separated by age and sport.
Child #2
Child's Name
Child's Name
Child's Date of Birth
Child's Date of Birth
Please note that groups will be separated by age and sport.
Child #3
Child's Name
Child's Name
Child's Date of Birth
Child's Date of Birth
Please note that groups will be separated by age and sport.
Child #4
Child's Name
Child's Name
Child's Date of Birth
Child's Date of Birth
Please note that groups will be separated by age and sport.
Child #5
Child's Name
Child's Name
Child's Date of Birth
Child's Date of Birth
Please note that groups will be separated by age and sport.
Emergency Contact *
Emergency Contact
Emergency Contact Number *
Emergency Contact Number
Name of Adult Permitted to Pick Up Child *
Name of Adult Permitted to Pick Up Child
Your child will only be released to the adults listed here.
Name of Adult Permitted to Pick Up Child
Name of Adult Permitted to Pick Up Child
Your child will only be released to the adults listed here.
Photo Release *
I give permission for photographs taken of me/my child/ward while participating in Mega Sports Camp to be used in marketing/public relations material in the promotion of City Life Philly and Mega Sports Camp.
Registration Cost *
I understand that Mega Sports Camp has a registration fee of $10 per child and will follow the link provided at the end of this form to pay the required cost under the Mega Sports Camp category.
PARENT/GUARDIAN AGREEMENT *
I agree to allow my child/ward to participate in the City Life's Mega Sports Camp and affirm that my child’s/ward’s participation is completely voluntary. I understand that there are risks inherent in the activities my child will engage in at Mega Sports Camp (some of which are described above) which may cause serious injury or even death. I also understand that, despite safety precautions, neither Mega Sports Camp nor City Life can guarantee that my child/ward will not be injured. My child/ward and I are willing to assume these risks. To minimize the risk, I have instructed my child/ward to obey all the rules, regulations and instructions of Mega Sports Camp.
TO ASSUME FULL RESPONSIBILITY FOR ANY RISKS OR LOSS, OR PERSONAL INJURY, INCLUDING DEATH *
In consideration for permitting me/my child/ward to participate in Mega Sports Camp, I voluntarily agree, for myself, my heirs, executors, and administrators, TO ASSUME FULL RESPONSIBILITY FOR ANY RISKS OR LOSS, OR PERSONAL INJURY, INCLUDING DEATH that may be sustained by me/my child/ward, or any loss or damage to property owned by me/my child/ward, as a result of training for, participating in, or traveling to or from Mega Sports Camp.
TO RELEASE, WAIVE, HOLD HARMLESS, DISCHARGE, & AGREE NOT TO SUE *
In consideration for permitting me/my child/ward to participate in Mega Sports Camp, I voluntarily agree, for myself, my heirs, executors, and administrators, TO RELEASE, WAIVE, HOLD HARMLESS, DISCHARGE, & AGREE NOT TO SUE the person or entity responsible for administering Mega Sports Camp, City Life, or its trustees, officers, employees, agents, students, and staff (hereinafter referred to as “releasees”) from any and all liability, claims, actions, demands, expenses, attorneys fees, breach of contract actions, breach of statutory duty, or other duty of care, warranty, strict liability actions, and causes of action whatsoever, that I might now have or may acquire in the future, arising out of or related to any loss, damage, or injury, including death, that may be sustained by me, or to any property belonging to me, while training for, traveling to or from, or participating in Mega Sports Camp.
MEDICAL EVALUATION *
I understand that I should obtain health insurance coverage prior to participating in Mega Sports Camp. I further understand that I will be responsible for my medical expenses.
By using my electronic signature below, I acknowledge that I have read, understand, and agree to the terms outlined above. *
By using my electronic signature below, I acknowledge that I have read, understand, and agree to the terms outlined above.