Youth Event and Activities: Participant Registration

Select Event(Required)

Child's Full Name(Required)

Athlete Email(Required)

Athlete Phone(Required)

Headshot(Required)

Max. file size: 9 MB.

Accepted file types: jpg, png, Max. file size: 9 MB.

Date of Birth(Required)

MM slash DD slash YYYY

Gender(Required)

Male

Female

Age(Required)

School(Required)

Grade(Required)

Classification(Required)

Graduation Year(Required)

GPA(Required)

ACT/SAT Score

Tribal Member(Required)

Yes

CDIB(Required)

Yes

Tribal Affiliation

T-Shirt Size(Required)

Team Name(Required)

Coach Name(Required)

Primary Position(Required)

Other Position(s)

Level Played(Required)

High School Varsity

High School Junior Varsity

Junior High

Dominant Hand(Required)

Right

Left

Notes and Stats

Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Parent/Guardian Name(Required)

By typing your legal full name into the box below you attest that you are the Legal Parent/Guardian authenticated into this application or an authorized user of this account, and the data you are entering/verifying is accurate and true to the best of your knowledge.

Parent/Guardian Phone Number(Required)

Parent/Guardian Email Address(Required)

Relationship to Child(Required)

Emergency Contact Name(Required)

Please make sure the emergency contact information is different than the guardian's contact information.

Emergency Contact Phone Number(Required)

School Coach Phone

School Coach Email

Travel Team Coach Phone

Travel Team Coach Email

Medical Notes(Required)

Do you have insurance?(Required)

Yes

If answered yes, please list insurance information

Parental Consent(Required)

By clicking the “I agree” button below, and/or by downloading, installing or otherwise using the software, you: (a) accept this agreement and agree that you are legally bound by its terms; and (b) represent and warrant that: (i) you are 18 years of age or older; and (ii) you have the right, power and authority to enter into this agreement for and on behalf of any minor children that participate in the activities. If you do not agree to the terms of this agreement, the nation will not and does not license the software to you and you must not download, install or use the software or documentation.

Participants Release and Waiver of Liability Agreement

Read Completely and Carefully Before Agreeing

This Waiver and Release of Liability and Indemnity Agreement (this “Release”) is given by the Parent or Legal Guardian of the minor child(ren) (the “Participant(s)”) in favor of the Choctaw Nation of Oklahoma (the “Nation”), a federally recognized sovereign Indian tribe.

I, the undersigned, as the parent or legal guardian of the Participant, and do hereby give my full consent and approval for the Participant to participate in the Choctaw Nation Youth Activities Program (the “Activities”).

I understand that there are certain risks of damages and injuries, including death, inherent in the Activities, and in other related activities incidental to participation in the Activities, and I am willing to assume these risks on behalf of myself and Participant. These risks include, but are not limited to, those hazards associated with weather conditions, playing conditions, equipment, and other participants.

Further, I understand that there is inherent risk in the Activities and that inherent risk means those dangers or conditions, known or unknown, which are characteristic of, intrinsic to, or an integral part of the Activities and which are not eliminated even if the activity providers (the “Providers”) acts with due care and includes failure by the Providers to warn me or Participant of an inherent risk or the risk that the Participant or another Participant in the Activity may act in a negligent or intentional manner and contribute to the injury or death of Participant.

I understand that Activities may actually be organized, directed, and presented by an individual(s) performing those duties as an independent contractor or specialist using Nation property. I further understand that this agreement applies to all Activities that my Participant is permitted to participate in, including, but not limited to: Sport Participant Instruction and Team Sports Activities (baseball, softball, soccer, basketball, football, etc.)

I understand and acknowledge that, I, as the parent or legal guardian of the Participant, am fully responsible for obtaining medical treatment for Participant.

In consideration for participation in the Activities, and on behalf of myself, Participant, my personal representative, heirs, next of kin, successors and assigns, I forever:
1. waive, release, discharge, and covenant not to sue the Nation and its elected officials, subsidiaries, affiliates, directors, officers, employees, independent contractors, consultants, and agents (the “Nation Parties”); and
2. agree to defend, indemnify, and hold harmless the Nation Parties from and against any and all claims, demands, causes of action and damages, including attorneys’ fees, resulting from any accident, incident or occurrence arising out of, incidental to, or in any way resulting from Participant’s involvement in the Activities.

I further affirm that by clicking the “I Agree” button, I am agreeing to all terms and conditions of this Release, and I recognize and agree to all terms and conditions of this Release on behalf of myself and on behalf of any Participants that are in my care. I have read this Release and fully understand that by agreeing to this Release I am giving up legal rights and/or remedies which may otherwise be available to me regarding any losses that I or Participant may sustain as a result of my participation in the Activities. I agree that if any portion of this Release is held invalid, the remainder will continue in full legal force and effect.

I acknowledge that I have read (or have had read to me) each and every one of the provisions in this waiver, release of liability and indemnification agreement, and that I understand each of the provisions in this agreement and that I agree to abide by them.

I agree

Guardian Signature(Required)

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