Keyz2Life Application - Sign Up!
Please fill out this form in its entirety. If you have any questions, email keyz2life.website@gmail.com.
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Full Name *
Email *
Primary Phone *
Secondary Phone *
Interests *
Age *
Gender *
Gender *
Current Grade *
School *
Home - Street Address *
City *
State *
Zip Code *
Country *
T-shirt Size *
1. Parent/ Guardian Name - Primary *
Parent/ Guardian Phone Number - Primary *
Parent/ Guardian Email
2. Parent/ Guardian Name
Parent/ Guardian Phone Number *
Parent/ Guardian Email
Emergency Contact Name (other than household) *
Child's Limitations and/or Cautions:
Special Requests (requests are not guaranteed)
I am willing to volunteer as a: *
Required

Everyone is Welcome: The KEYZ 2 LIFE is a non-profit organization open to all individuals. Insurance: It is the responsibility of every individual, their parent or legal guardian, to provide their own

accident and health coverage while participating in all KEYZ 2 LIFE activities. KEYZ 2 LIFE does not provide any such coverage for its participants.

AUTHORIZATIONS and RELEASE:
Photograph Permission: I give permission for the KEYZ 2 LIFE to use any pictures of my child for

future promotional purposes.

Medical Treatment: I hereby give permission for my child to be given cardiopulmonary resuscitation (CPR) and first aid treatment by a qualified staff member of the KEYZ 2 LIFE organization. In the event I cannot be contacted, I also give permission for my child to be transported by ambulance or aid car to an emergency center for treatment. I further consent to the disclosure of health information and to the medical, surgical and hospital care treatment and procedures (including, but not limited to, administration of necessary anesthetics, tests, x-ray examinations, transfusions, injections, drugs) to be performed for my child by a licensed physician or hospital selected by the KEYZ 2 LIFE director when deemed immediately necessary or advisable by the physician to safeguard my child’s health.

Release from Liability: Recognizing that the KEYZ 2 LIFE will do its best to ensure a safe experience, I understand that accidents may occur both from my child’s participation in youth sports activities and from transportation to and from the program. I agree to assume these risks. By signing below, I release the KEYZ 2 LIFE, its employees, volunteers, independent contractors, directors and agents from all liability based on any damage, loss or injury whether it is the result of ordinary negligence or otherwise, caused to my child or to me, from participation in the youth sports program.

I have read and understand the above and have completed this form to the best of my ability. I also support the KEYZ 2 LIFE youth sports philosophy, which is based on participation, fun, physical fitness and health, skill development, teamwork, fair play, family involvement and volunteer

***PLEASE TYPE YOUR NAME BELOW AS YOUR SIGNATURE

Signature of Parent or Legal Guardian

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