Register with discounts Soccer 2024

Please fill out the registration form and someone form our team will contact you regarding scholarship opportunities. Please note that a separate registration must be completed for each child.

REGISTRATION

CHILD'S INFORMATION

Child's First Name

Child's Last Name

Child's Age

Birthday

Please Indicate M/F

Male

Female

PARENT/GUARDIAN INFORMATION

Parent/ Guardian First Name

Parent/ Guardian Last Name

Phone

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Parent's Email

I want to subscribe to the newsletter.

Emergency Contact Name

Emergency Contact Phone

Special Child Medical Concerns

Medical Insurance Company

Group Number

PARENTAL CERTIFICATION, CONSENT AND RELEASE CONSENT FOR MEDICAL TREATMENT OF A MINOR

PLEASE READ AND SIGN. BY SIGNING, YOU ARE ACKNOWLEDGING AND AGREEING TO THE FOLLOWING:

I acknowledge that I am the legal guardian of the child whose name is entered here. I warrant that I possess all the rights, powers, and privileges of a parent or legal guardian necessary to execute this legal instrument with binding legal effect.

I certify and affirm that I have been completely and thoroughly informed that as a youth attending an Athletes International Ministries (AIM) event, my child will participate in certain activities which carry with them a degree of risk and danger. Examples of risky and dangerous activities include, but are not limited to:

1. Physical activities, both indoors and outdoors;

2. Sports, both informal and organized; swimming /boating;

3. Use of recreational equipment;

4. Field trips, both on and off campus;

5. Travel by automobile;

6. Activities around water, including

7. Hiking ,camping, horseback riding

8. Construction and maintenance projects.

I acknowledge and understand that AIM may offer other activities not listed above that present similar risks or dangers to my child. I consent to my child's participation in these activities. I acknowledge andunderstand that this PARENTAL CERTIFICATION, CONSENT AND RELEASE has the same force and effect regardless of whether the activities engaged in are free or if a fee is charged. Further, I personally assume, on my child's behalf, all risk in connection with and said activities for any harm, injury or damages that may befall my child as a result of my child's participation in the activities, whether foreseen or unforeseen, and I still wish to allow my child to proceed with the activities. I acknowledge and agree that AIM shall not be held liable in any way for any occurrence resulting directly or indirectly from these activities that results in injury, death or any other damages to my child, me, or my family, heirs, or assigns. In consideration of my child being allowed to participate in these activities, on behalf of my child, I hereby personally assume all risk in connection with said activities, for any harm, injury, or damage that may befall my child, me or my family, heirs, or assigns while engaged in such activities.

I understand that the terms herein are contractual and not mere recital; have signed this document as my own free act. It is my intention by signing this document to exempt and· release AIM from all liability whatsoever for personal injury, property damage or wrongful death caused by negligence. I further acknowledge and agree that my signature on the PARENTAL CERTIFICATION, CONSENT AND RELEASE shall constitute a bar to any recovery by my child, me or my family, heirs or assigns in all suits and actions that may be instituted against AIM, it's agents, servants or employees for injuries or death to my child, whether or not same resulted from the negligence of AIM, it's agent, servants or employees, or due to the negligence of my child, or due to the risks ordinarily incident to my child's participation in these activities, or due to the contributory negligence of my child. I understand that it is my obligation to inform the management of AIM of any and all health considerations or medical conditions that.would restrict my child's participation in any and all activities involving AIM or its programs.

I have fully informed myself of the contents of the PARENTAL CERTIFICATION, CONSENT AND RELEASE by reading it before I signed it.

Your Signature 1

CONSENT FOR MEDICAL TREATMENT
OF A MINOR

I consent to the examination or treatment of my child by a physician duly licensed to practice medicine or any health care professional duly licensed to provide health care services for medical care and services deemed necessary by AIM, its agents, servants, and employees. I give permission to the Doctor or health care professional to provide any and all medical care they deem, in their professional opinion, to be necessary.

I understand and acknoweldge that my permission and consent is sufficient for this purpose. I represent to AIM that now permission or consent from any other person is required by law.

I agree to pay for any and all medical expenses incurred as a result of the use of the consent. I understand that it is my obligaiton to inform the management of AIM of any and all health considerations or medical restrictions that would restrict my child's participation in any and all activities while at an AIM event or program.

Should the need for medical attention arise, AIM will attempt to contact you as soon as practicable under the circumstances.

Your Signature 2

PHOTO RELEASE

I give Athletes International Ministries, Inc. permission to publish in print, electronic, or video format, the likeness or image of my child. I release all claims against AIM with respect to copyright ownership and publications including any claims for compensation related to use of the materials/ data.

Your Signature 3

Thanks for registering! Someone from our team will be in touch with you to discuss next steps.