Youth Sports Nonprofit Consent and Release of Liability Form

Participant Information

Participant Name Date of Birth Address

Parent or Guardian Information

Parent/Guardian Name Phone Number Email

Emergency Contact

Emergency Contact Name Emergency Contact Phone

Medical Information

Please list any allergies, medical conditions, or medications

Consent and Release

I, the undersigned, hereby give permission for my child to participate in the programs and activities of the youth sports nonprofit. I understand that there are inherent risks associated with athletic activities and agree to release, indemnify, and hold harmless the organization from any claims arising from participation. I certify that my child is in good health and has my consent to participate.