Winter League Registration – ENVISION SPORTS ACADEMY

Name*

First Last

Gender*

Date of Birth*

Age*

Grade Level*

T-Shirt Size*

Parent Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Phone*

Emergency Contact*

Emergency Number*

Injury and Media Waiver*

I do hereby absolve Envision Sports LLC, & Envision Sports Academy LLC its facilities, staff, coaches, partners and affiliates of any and all liability that any hurt, harm or injury that may occur during the voluntary participation. I also understand that during the voluntary participation of games, practice, instructional lessons, workouts and other physical activity, the well-being of my child is at the utmost of concern. I also understand that with any physical activity, injury is always a possibility. In case of injury, I give full permission to the Envision Sports LLC staff, and or its delegates to take the appropriate steps, and to also contact EMS, if emergency medical attention is needed. I also agree to allow my child to be photographed or recorded and published on Envision Sports LLC media platforms for informative, enjoyment, and marketing purposes.

I, Agree

League Registration Fee*

Price: $215.00

Registration Fee: $215

Discount Code

Total

$0.00

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