Dr. Toni Bilbao Preparatory School

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SUBSCRIPTION FORM

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SCHOOL NAME: Dr. Toni Bilbao Preparatory School

SPORT

GRADE

CHILD’S NAMES

GENDER

DATE OF BIRTH

AGE

SIZE

HOMEROOM TEACHER

ALLERGIES/MEDICAL INFORMATION/OTHER

PARENT/GUARDIAN NAMES

EMAIL ADDRESS

ADDRESS

PHONE NUMBER

EMERGENCY CONTACT NAMES

EMERGENCY CONTACT PHONE

AGREEMENT

LECEL ACADEMY HAS MY CONSENT TO PHOTOGRAPH MY CHILD FOR PUBLIC RELATIONS, ACADEMY PROMOTIONS OR ARCHIVAL PURPOSES ONLY. WE ARE NOT RESPONSIBLE FOR CANCELLATIONS DUE TO BAD WEATHER, HOLIDAYS OR AREA MAINTENANCE. I CONFIRM THAT MY CHILD LISTED ABOVE IS IN GOOD HEALTH AND IS FULLY ABLE TO PARTICIPATE IN THE SPORT ACTIVITIES HELD AT OR BY LECEL ACADEMY. IN CONSIDERATION FOR MY CHILD BEING ALLOWED TO PARTICIPATE IN THE TEAM, I HEREBY RELEASE LECEL ACADEMY, THE SCHOOL, ITS BOARD OF DIRECTORS, EMPLOYEES, OFFICERS, VOLUNTEERS, COACHES AND AGENTS FROM LIABILITY FOR ANY AND ALL CLAIMS, INCLUDING CLAIMS OF NEGLIGENCE, RESULTING IN ACCIDENT, INJURY, SICKNESS, DEATH, ECONOMIC LOSS, ETC. OF ANY NATURE WHATSOEVER TO PERSON OR PROPERTY RESULTING IN ANY WAY FROM OR IN ANY FASHION ARISING FROM, CONNECTED WITH OR RESULTING FROM PARTICIPATION IN THE TEAM. I, AS PARENT/GUARDIAN, UNDERSTAND THAT SOCCER, BASKETBALL OR VOLLEYBALL CAN BE A DANGEROUS SPORT. BY SIGNING THIS FORM, WE UNDERSTAND THAT THE POSSIBILITY OF INJURY DOES EXIST AND ACCEPT ALL RISK AND RESPONSIBILITY ASSOCIATED WITH THE SPORTS.