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Top of the Key Free Assessment Registration

Player's First Name *

Player's Last Name *

Gender *

MaleFemale

Date of Birth *

Grade *

School *

Please indicate what day and time you plan to attend your Free Assessment at Top of the Key:

Date/Time *

Parent Info

Parent's First Name *

Parent's Last Name *

Parent's Cell Phone *

Parent's email *

How did you hear about Top of the Key? *

Waiver

Does the participant have any medical conditions, health concern, allergies or special needs that we should be aware of? *

yesNo

If yes, describe here:

Do you have medical insurance? *

YesNo

I hereby waive and release the host facility, Top of the Key and all employees and volunteers from damages and injuries to my person, child and/or property, which may be suffered by me, arising from my travels to or from the lessons, camps, clinics and/or participation in any Top of the Key event. I agree to adhere to all of the Covid 19 guidelines set forth by the state and the host facility. I hereby agree that the photographs, video recordings, newspaper, television or radio interviews of myself or my child may be used in the promotion of, and for the purposes of Top of the Key without any compensation to me whatsoever. I also assert that my child is in good health, and has been cleared by a doctor to participate in rigorous physical activity.

Electronic signature: I/We have read, understand and agree to comply with the Waiver as outlined above. *

YesNo