HYSA

Howard Youth Sports Association

Registration

Registering for:

Residence Howard Suamico Other Player's Name: Address: City: Zip: Date of Birth (mm/dd/yyyy): Age: Grade: School:

Primary Parent/Guardian: Primary Phone: Secondary Phone: Email: Secondary Parent/Guardian: Primary Phone: Secondary Phone: Email:

Doctor: Doctor Contact Number: Medical Info: Allergies: Medication: Contact Lenses? Yes

Terms

By checking the box below you agree to the following terms:

I understand participation in Howard Youth Sports Association programs involve an element of risk or danger for all participants and may cause serious injury, death or property loss. I agree to assume these risks for my family and release the Village of Howard, its employees and other participants from any liability for injuries and damages sustained while participating in these programs. I understand a physician's approval is encouraged prior to participation. I also hereby give my permission for emergency medical treatment should the need arise.

I agree to these terms