CDYC Registration 2020

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Middle School: June 21-24
High School: June 25-28
$250

Email *

What's participants first name? *

What's participants last name? *

Please indicate male/female *

Female

Male

What is the participant's grade? (current grade) *

Middle School Adult Leader

High School Adult Leader

What is the participants shirt size? *

XXL

*MIDDLE SCHOOL ONLY: Which track would the participant like to do in the afternoons?

3v3 Basketball Tournament

Sand Volleyball Tournament

Art - A guided canvas painting experience

Serve

Nerf - A variety of battle complete with an arsenal of nerf guns and bunkers

Ping Pong Tournament

Clear selection

*MIDDLE SCHOOL ONLY: Will the participant be performing a talent at the open mic nights? if so, please share what the talent will be

*HIGH SCHOOL ONLY: Would you like to participate in Basketball tournament? (sign up for teams at RSM)

Yes

Clear selection

What allergies does the participant have? *

Who would the participant like to room with? (not required)

What is the parent's or guardian's phone number? *

What is the participant's cell phone number? (answer "NA" if they don't have one) *

Please indicate your insurance company *

Please indicate your insurance group/policy number *

What medical needs does the participant have? (perscriptions, etc.) include instructions if necessary. *

I acknowledge that participation in the activity described above involves risk to the participant (and tothe participant’s parents or guardians, if the participant is a minor), and may result in various types ofinjury including, but not limited to, the following: sickness, bodily injury, death, emotional injury,personal injury, property damage, and financial damage.In consideration for the opportunity to participate in the activity described above (the “activity”), theparticipant (or parent/guardian if the participant is a minor) acknowledges and accepts the risks ofinjury associated with participation in and transportation to and from the activity. The participant (orparent/guardian) accepts personal financial responsibility for any injury or other loss sustained duringthe activity or during transportation to and from the activity, as well as for any medical treatmentrendered to the participant that is authorized by the sponsor or its agents, employees, volunteers, orany other representatives (collectively referred to as the “activity sponsor”). Further, the participant(or parent/guardian) releases and promises to indemnify, defend, and hold harmless the activitysponsor for any injury arising directly or indirectly out of the described activity or transportation toand from the activity, whether such injury arises out of the negligence of the activity sponsor, theparticipant, or otherwise.If a dispute over this agreement or any claim for damages arises, the participant (or parent/guardian)agrees to resolve the matter through a mutually acceptable alternative dispute resolution process. Ifthe participant (or parent/guardian) and the activity sponsor cannot agree upon such a process, thedispute will be submitted to a three-member arbitration panel for resolution in accordance with therules of the American Arbitration Association. *

I accept

I do not accept

A parent signature is needed. Please indicate your affirmation of the above information and parental release by typing parent/guardian's name here: *

Send me a copy of my responses.

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