© 2006-2009 Christian Youth Sports Association.  All rights reserved.

Transportation Service

Football

Cheer

Winter Basketball
Program:
check one
Participant Gender:
Participant Age:
 Participant Date of Birth:
Participant Last Name:                                                                        Participant First Name:
Mother /Guardian Contact 1 Last Name:                                            Mother/Guardian Contact 1 First Name:
Mother /Guardian Address:
street                                                                                   Apt No.                        City                                        Zip                     
Mother /Guardian Phone Numbers:
Home Phone Number                                                  Work Phone Number                                                    Cell Phone Number
Mother /Guardian E-Mail Address:
Father/Guardian Contact 2 Last Name:                                               Father/Guardian Contact 2 First Name:
Father/Guardian Address:
street                                                                                   Apt No.                        City                                        Zip                     
Father/Guardian Phone Numbers:
Home Phone Number                                                  Work Phone Number                                                    Cell Phone Number
Father /Guardian E-Mail Address:
I, THE PARTICIPANTS PARENT/GUARDIAN, UNDERSTAND THE
NATURE OF THIS ACTIVITY AND THIS PARTICIPANT'S EXPERIENCE. THE
PARTICIPANT IS IN GOOD HEALTH AND IN PROPER PHYSICAL
CONDITION TO PARTICIPATE IN SPORTS & RECREATIONAL ACTIVITIES. I
RELEASE, DISCHARGE, COVENANT NOT TO SUE, AND AGREE TO INDEMNIFY,
SAVE AND HOLD HARMLESS CYSA FROM ALL LIABILITY CLAIMS, DEMANDS,
LOSSES OR DAMAGES ON
THIS PARTICIPANT'S ACCOUNT CAUSED OR ALLEGED TO BE
CAUSED IN WHOLE OR IN PARR BY THE NEGLIGENCE OF CYSA OR OTHERWISE.
I FURTHER AGREE THAT IF DESPITE THIS RELEASE, I THE PARTICIPANT OR
ANYONE ON THE PARTICIPANT'S BEHALF MAKES A CLAIM AGAINST CYSA, I
WILL INDEMNIFY, SAVE, AND HOLD HARMLESS CYSA FROM ANY LITIGATION
EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE, OR COST ANY MAY
INCUR AS A RESULT OF ANY SUCH CLAIM.

BY CLICKING REGISTER NOW YOU AGREE TO THESE TERMS.
Player Experience:
Years Played:
T-Shirt/Jersey Size:
Short Size: