REGISTRATION FORMS

Please select the age group you would like to purchase and register for. *

A. REGISTRANT

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Date of Birth * +

Height (inches) *

Weight *

Phone Number *

Email Address *

Please email me camp updates.

High School

Grade Level *

Expected Year of Graduation *

Position

High School Coach's First Name

High School Coach's Last Name

High School Coach's Email

Club Field Hockey Team

Club Coach's First Name

Club Coach's Last Name

Club Coach's Email

B. MEDICAL AND INSURANCE

Each Registrant is required to have their own health insurance.

Health Insurance Company *

Policy Number *

Group Number

C. EMERGENCY CONTACT

Emergency Contact Name *

Relationship to Registrant *

Primary Contact Telephone Number *

D. PRIMARY PARENT/GUARDIAN

First Name

Last Name

Phone Number

Email Address

E. LIABILITY WAIVER/CONSENT TO TREAT

This is to certify that I am the parent or guardian of the above mentioned registrant listed above in Section D, and that I give my consent to the representative(s) of Full Swing Field Hockey, LLC. to obtain medical care from any licensed physician, hospital, or clinic for the above mentioned registrant, for any injury or illness that could arise during the duration of the program for which we are registering. Additionally, this certifies that the above mentioned registrant listed in Section D, and the parent/guardian of the registrant, consents to the complete and unconditional acceptance the terms and conditions, protocols and guidelines set forth by Full Swing Field Hockey, LLC., the CDC, state, and local government agencies regarding COVID-19.

Further, in consideration of the participant being permitted to register and participate in any Full Swing Field Hockey, LLC., a Maryland limited liability company, event (camps, clinics, training, and tournaments), I understand that there are many risks inherent in and incidental to (including communicable diseases), and do hereby release and discharge Full Swing Field Hockey directors, agents, employees and any person or corporation or partnership connected herewith from all manner of action, injury, damages, costs, claims or demands which we will, shall or may hereinafter have, suffer or receive by reason of such participation in any program at the center. This release shall be binding on our heirs, assigns, executors and administrators. It is further agreed that Full Swing Field Hockey, LLC. shall not be considered to guarantee or warrant such equipment as may be used in the conditioning of said programs. The undersigned also agrees that their likeness or the likeness of their child may be photographed or videotaped and that such image may be published in an outlet used to promote or publicize the program.

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