horns united youth sports organization registration form
HORNS UNITED YOUTH SPORTS ORGANIZATION REGISTRATION FORM CIRCLE ONE:
PARTICIPANT’S INFORMATION #1 Participant’s Last Name:
FOOTBALL
First:
GENDER (circle one): MALE FEMALE
Age as of August 1st:
Please list 4 options for Jersey #
Option 1:
CHEER
Birthdate:
Grade:
Shoe Size:
Option 2:
T-SHIRT SIZE: Option 3:
Option 4:
Allergies/Medical Conditions:
PARTICIPANT’S INFORMATION #2 Participant’s Last Name:
CIRCLE ONE:
FOOTBALL
First:
CHEER
Birthdate:
GENDER (circle one): MALE FEMALE
Age as of August 1st:
Grade:
Please list 4 options for Jersey #
Option 1:
Option 2:
T-SHIRT SIZE:
Shoe Size:
Option 3:
Option 4:
Allergies/Medical Conditions:
CIRCLE ONE:
PARTICIPANT’S INFORMATION #3 Participant’s Last Name:
FOOTBALL
First:
CHEER
Birthdate:
GENDER (circle one): MALE FEMALE
Age as of August 1st:
Grade:
Please list 4 options for Jersey #
Option 1:
Option 2:
T-SHIRT SIZE:
Shoe Size: Option 3:
Option 4:
Allergies/Medical Conditions:
Would you like to volunteer as (circle one): Asst. Team Manager Asst. Coach Event/Game Day Volunteer Stand I would like to add additional fees:
Post-Game Snack ($10) Qty:
Last Name on Jersey ($7) Qty:
Chain Crew (Game Day) Practice Jersey ($22) Qty:
Concession
Helmet ($87) Qty:
Below is for office use: Date Received _________________ Payment Amount ___________________ Cash _______ Check# ____________ Payment Plan __________ Payment Received by ________________________________________________
PARENT/GUARDIAN INFORMATION PARENT/GUARDIAN #1 Last Name:
First:
Relationship:
Phone:
Email Address:
Address: City:
State: TX
Zip Code:
PARENT/GUARDIAN #2 Last Name:
First:
Phone:
Relationship:
Email Address:
Address: City:
State: TX
Zip Code:
PARENT/GUARDIAN #3 Last Name: Phone:
First:
Relationship:
Email Address:
Address: City:
State: TX
Zip Code:
WAIVERS
______ Initial
NEW REQUIREMENT FOR 2018: ALL FOOTBALL PLAYERS ARE REQUIRED TO HAVE STATE ISSUED IDENTIFICATION! Please obtain this as soon as possible so that you'll have enough time to receive the HARD COPY in the mail. Visit www.dps.texas.gov to view the requirements and application needed to obtain state issued identification. CHEERLEADERS MUST HAVE THEIR ORIGINAL BIRTH CERTIFICATE w/ the state seal. PAPER COPIES WILL NOT BE ACCEPTED!!!
______ Initial
MEDICAL RELEASE: In consideration of the acceptance of my application for my child with the HORNS UNITED YOUTH SPORTS ORGANIZATION and for my child to be fully permitted to engage in the activities of the HUYSO, I, for myself and my child, hereby waive, release, and discharge any and all claims for damages for fatal injury, personal injury or property damage, whether or not resulting from the negligence, gross negligence or misconduct of any person, that I may have, or that may subsequently accrue to me, as a result of my child’s participation in the activities of the HUYSO. This release is intended to discharge in advance the board of directors, organizers, sponsors, supervisors, other participants, persons transporting my child to and from activities, officials, and any municipalities or other public entities (including their respective agents and employees), from and against any and all liability arising out of or connected in any way with my child’s participation in any HUYSO activities, even though that liability may arise out of negligence or carelessness on the part of the persons or entities mentioned above. I further understand that serious accidents occasionally occur during football, cheerleading, baseball, basketball, and/or track and field activities and that participants in such activities occasionally sustain serious personal injuries as a consequence thereof. Knowing the risks of these activities, nevertheless, I hereby agree on my own behalf and that of my child to assume those risks and to release and to hold harmless all of the persons or entities mentioned above who (through negligence or carelessness) might otherwise be liable to me or my child (or to our heirs or assigns) for damages. It is further understood and agreed that this waiver, release, and assumption of risk is to be binding on my heirs, and assigns as well as those of my child. I understand and agree that the liability insurance carried by the HUYSO and/or the TSYL is only secondary insurance to my own personal insurance coverage, which I acknowledge is current and will remain current during the playing season. I give my child’s head coach, his/her assistant, team manager, or staff the right to seek medical treatment in case of injury if I cannot be located. I also release all official and professional personnel from any claim whatsoever on account of first aid, treatment or service rendered to my child during participation in a HUYSO activity. I have identified all medical problems that the HUYSO should be aware of and have provided all special instructions in the Medical Emergency Information section.
______ Initial
PLAYER / CHEERLEADER VERIFICATION WAIVER: Players and cheerleaders must attend a Mandatory Certification Day, August 4, 2018. Location and time will be provided at a later date. Please plan on attending. Players and Cheerleaders will not be able to play until they certify. If you miss the certification date players and cheerleaders must certify at the TSYL office in Fort Worth.
Parent’s Signature __________________________________________________ Date______________________
PARTICIPANT’S INFORMATION #1 Participant’s Last Name:
FOOTBALL
First:
GENDER (circle one): MALE FEMALE
Age as of August 1st:
Please list 4 options for Jersey #
Option 1:
CHEER
Birthdate:
Grade:
Shoe Size:
Option 2:
T-SHIRT SIZE: Option 3:
Option 4:
Allergies/Medical Conditions:
PARTICIPANT’S INFORMATION #2 Participant’s Last Name:
CIRCLE ONE:
FOOTBALL
First:
CHEER
Birthdate:
GENDER (circle one): MALE FEMALE
Age as of August 1st:
Grade:
Please list 4 options for Jersey #
Option 1:
Option 2:
T-SHIRT SIZE:
Shoe Size:
Option 3:
Option 4:
Allergies/Medical Conditions:
CIRCLE ONE:
PARTICIPANT’S INFORMATION #3 Participant’s Last Name:
FOOTBALL
First:
CHEER
Birthdate:
GENDER (circle one): MALE FEMALE
Age as of August 1st:
Grade:
Please list 4 options for Jersey #
Option 1:
Option 2:
T-SHIRT SIZE:
Shoe Size: Option 3:
Option 4:
Allergies/Medical Conditions:
Would you like to volunteer as (circle one): Asst. Team Manager Asst. Coach Event/Game Day Volunteer Stand I would like to add additional fees:
Post-Game Snack ($10) Qty:
Last Name on Jersey ($7) Qty:
Chain Crew (Game Day) Practice Jersey ($22) Qty:
Concession
Helmet ($87) Qty:
Below is for office use: Date Received _________________ Payment Amount ___________________ Cash _______ Check# ____________ Payment Plan __________ Payment Received by ________________________________________________
PARENT/GUARDIAN INFORMATION PARENT/GUARDIAN #1 Last Name:
First:
Relationship:
Phone:
Email Address:
Address: City:
State: TX
Zip Code:
PARENT/GUARDIAN #2 Last Name:
First:
Phone:
Relationship:
Email Address:
Address: City:
State: TX
Zip Code:
PARENT/GUARDIAN #3 Last Name: Phone:
First:
Relationship:
Email Address:
Address: City:
State: TX
Zip Code:
WAIVERS
______ Initial
NEW REQUIREMENT FOR 2018: ALL FOOTBALL PLAYERS ARE REQUIRED TO HAVE STATE ISSUED IDENTIFICATION! Please obtain this as soon as possible so that you'll have enough time to receive the HARD COPY in the mail. Visit www.dps.texas.gov to view the requirements and application needed to obtain state issued identification. CHEERLEADERS MUST HAVE THEIR ORIGINAL BIRTH CERTIFICATE w/ the state seal. PAPER COPIES WILL NOT BE ACCEPTED!!!
______ Initial
MEDICAL RELEASE: In consideration of the acceptance of my application for my child with the HORNS UNITED YOUTH SPORTS ORGANIZATION and for my child to be fully permitted to engage in the activities of the HUYSO, I, for myself and my child, hereby waive, release, and discharge any and all claims for damages for fatal injury, personal injury or property damage, whether or not resulting from the negligence, gross negligence or misconduct of any person, that I may have, or that may subsequently accrue to me, as a result of my child’s participation in the activities of the HUYSO. This release is intended to discharge in advance the board of directors, organizers, sponsors, supervisors, other participants, persons transporting my child to and from activities, officials, and any municipalities or other public entities (including their respective agents and employees), from and against any and all liability arising out of or connected in any way with my child’s participation in any HUYSO activities, even though that liability may arise out of negligence or carelessness on the part of the persons or entities mentioned above. I further understand that serious accidents occasionally occur during football, cheerleading, baseball, basketball, and/or track and field activities and that participants in such activities occasionally sustain serious personal injuries as a consequence thereof. Knowing the risks of these activities, nevertheless, I hereby agree on my own behalf and that of my child to assume those risks and to release and to hold harmless all of the persons or entities mentioned above who (through negligence or carelessness) might otherwise be liable to me or my child (or to our heirs or assigns) for damages. It is further understood and agreed that this waiver, release, and assumption of risk is to be binding on my heirs, and assigns as well as those of my child. I understand and agree that the liability insurance carried by the HUYSO and/or the TSYL is only secondary insurance to my own personal insurance coverage, which I acknowledge is current and will remain current during the playing season. I give my child’s head coach, his/her assistant, team manager, or staff the right to seek medical treatment in case of injury if I cannot be located. I also release all official and professional personnel from any claim whatsoever on account of first aid, treatment or service rendered to my child during participation in a HUYSO activity. I have identified all medical problems that the HUYSO should be aware of and have provided all special instructions in the Medical Emergency Information section.
______ Initial
PLAYER / CHEERLEADER VERIFICATION WAIVER: Players and cheerleaders must attend a Mandatory Certification Day, August 4, 2018. Location and time will be provided at a later date. Please plan on attending. Players and Cheerleaders will not be able to play until they certify. If you miss the certification date players and cheerleaders must certify at the TSYL office in Fort Worth.
Parent’s Signature __________________________________________________ Date______________________
