Participant 1 Full Name *

Participant 1 School *

Participant 1 Grade *

Kindergarten

Grade 1

Grade 2

Participant 1 Shirt Size *

ALL SIZES ARE YOUTH SIZES

Participant 1 Short Size *

ALL SIZES ARE YOUTH SIZES

Parent/Guardian Full Name *

Second Parent/Guardian Full Name *

Gender *

Address *

Email *

Phone *

Is the child's emergency contact person different from the child's parent?

Emergency Contact Name

Emergency Contact Number

Do you want to add a sibling? *

Yes

Participant 2 Full Name *

Participant 2 School *

Participant 2 Grade *

Kindergarten

Grade 1

Grade 2

Participant 2 Shirt Size *

ALL SIZES ARE YOUTH SIZES

Participant 2 Short Size *

ALL SIZES ARE YOUTH SIZES

Participant 2 Parent/Guardian Full Name *

Participant 2, Second Parent/Guardian Full Name *

Gender *

Participant 2, Address *

Participant 2, Email *

Participant 2, Phone *

Participant 2, EMERGENCY CONTACT

Do you want to add a sibling? *

Yes

Participant 3 Full Name *

Participant 3 School *

Participant 3 Grade *

Kindergarten

Grade 1

Grade 2

Participant 3 Shirt Size *

ALL SIZES ARE YOUTH SIZES

Participant 3 Short Size *

ALL SIZES ARE YOUTH SIZES

Participant 3 Parent/Guardian Full Name *

Participant 3 Second Parent/Guardian Full Name *

Gender *

Participant 3, Address *

Participant 3, Email *

Participant 3, Phone *

Participant 3, EMERGENCY CONTACT

Do you want to add a sibling? *

Yes

Participant 4 Full Name *

Participant 4 School *

Participant 4 Grade *

Kindergarten

Grade 1

Grade 2

Participant 4 Shirt Size *

Participant 4 Short Size *

Participant 4 Parent/Guardian Full Name *

Participant 4, Second Parent/Guardian Full Name *

Gender *

Participant 4, Address *

Participant 4, Email *

Participant 4, Phone *

Participant 4, EMERGENCY CONTACT

Waiver and Release of Liability

PLEASE REVIEW CAREFULLY AS YOU ARE SIGNING AWAY CERTAIN RIGHTSAND LIMITING OTHERS.

Gem City Athletic League, Inc. (“Gem City”) provides the undersigned and the general public with physical education, sports training, skills training, and other related services (the “Program”).

The undersigned hereby acknowledges and agrees to the following: The undersigned is physically fit and able to participate in the Program and, prior to participation in the Program, the undersigned has consulted a physician regarding any limitations or medical risks that the undersigned may have in relation to the Program. The undersigned certifies that the undersigned is free from any such limitations and medical risks.

The undersigned understands and agrees that the Program involves physical exertion and strenuous physical activity, which entails certain risks of serious bodily injury, property damage, and/or death. With full knowledge of the risks involved in the Program, the undersigned voluntarily chooses to participate in the Program and hereby forever releases, covenants not to sue, discharges, and waives all liability on behalf of Gem City, its employees, executives, officers, directors, board members, affiliates, owners, subsidiaries, partners, sponsors, agents, assigns, lessees of the premises, owners of the premises, consultants, volunteers, athletic directors, training directors, contractors, and any other personnel associated with Gem City and Marietta City Schools, its employees, executives, officers, directors, board members, affiliates, owners, subsidiaries, partners, sponsors, agents, assigns, lessees of the premises, owners of the premises, consultants, volunteers, athletic directors, training directors, contractors, and any other personnel associated with Marietta City Schools (the “Releasees”) for any bodily injury of any kind, property damage, or death, suffered by the undersigned as a result of the undersigned’s participation in the Program, regardless of whether such bodily injury, property damage, or death was due to negligence of any kind committed by Gem City, Marietta City Schools, Releasees, or otherwise. The undersigned agrees to indemnify and hold harmless Gem City, Marietta City Schools, and Releasees from any loss, liability or cost he/she may incur arising out of or related to the undersigned’s participation in the Program and assumes full responsibility for any injury, property damage, or death arising out of or related to the undersigned’s participation in the Program and/or use of the premises and/or equipment provided by Gem City and/or Marietta City Schools.

Notwithstanding the undersigned’s covenant not to sue Releasees and without Releasees waiving any rights herein, the undersigned agrees that, in the event of any legal action, all such legal proceedings, including regarding the enforceability of this waiver, shall be arbitrated pursuant to the Federal Arbitration Act, and such arbitration shall be the exclusive, final, and binding remedy. The parties agree that the arbitration shall take place in Cobb County, Georgia and will be conducted by and through the American Arbitration Association (the “AAA”), applying the laws of the State of Georgia (without giving effect to its conflict of laws principles). The arbitration shall take place before a single arbitrator with experience related to the legal nature of the dispute and jointly selected (or appointed by the AAA if the parties are unable to come to an agreement within ten (10) days). The non-prevailing party shall be responsible for the cost of the arbitration.

he undersigned certifies that he/she has read the foregoing and understands that, by signing below, he/she is giving up certain legal rights and remedies. The undersigned understands that he/she has the right to consult legal counsel prior to signing this document. The undersigned understands that his/her signature on this document will be a complete and unconditional release of all liability on behalf of Gem City and the Releasees to the greatest extent permitted by law.

Guardian's Signature *

Clear

SOCIAL MEDIA RELEASE

The undersigned hereby authorizes Gem City Athletic League, Inc. (“Gem City”) to record my name, likeness, image, voice, and participation in film, tape, photograph, or otherwise for use in all Gem City related initiatives. The undersigned agrees that all photo, video, and other production related materials may be edited and otherwise altered at the sole discretion of Gem City and used in whole or in part at the sole discretion of Gem City and its Board of Directors, whether it be for public or private use. The undersigned further agrees that the undersigned has no rights to any production related to Gem City or any benefits derived therefrom, thereby irrevocably and unconditionally releasing and waiving all rights, legal and moral, so that Gem City may fully
utilize the undersigned’s name, likeness, image, voice, and participation in film, tape, social media, or otherwise.
Gem City agrees to comply with applicable privacy laws.

Guardian's Signature *

Clear