First and Last name of the Player who will be trying out for travel baseball.

NOTE: Be sure to put the correct birth year.

Based on Player's age on May 1st 2021. (A player who is 9 years old on May 1st 2021 will choose 9U or above)

Choose the grade your player is enrolled in for the 2020-2021 school year

What school does the player attend?

Name of parent(s) / guardian(s)

Street address of the Player

Parent/Guardian phone number(s)(leave a space between multiple phone numbers)

Enter any other parent/guardian email addresses you would like notified regarding this player.

Prior to participation or use of Board facilities or equipment, the Participant will conduct a daily symptom assessment (self-evaluation) and will stay at home if experiencing symptoms of fever, cough, shortness of breath or difficulty breathing, chills, muscle pain, headaches, sore throat, or new loss of taste or smell. TheRegistrant will stay at home if he/she has been exposed to any person who has tested positive for COVID-19 in the past fourteen (14) days.

The Parent/Guardian and Participant understand that participation in the above-identified activity involves risks and dangers including, but not limited to accidents, illnesses, and death, including but not limited to COVID-19 and any related or derivative disease or condition. In exchange for the Board allowing the Registrant to participate in the activity, the undersigned hereby assumes all risks of participation in the activity including those set forth above and releases, discharges, and/or waives any and all liability, claims, damages, causes of action and/or demands against the Lakewood City School District Board of Education (“Board”) and its employees of every kind and nature which may arise from or in connection with the activity. The undersigned further agrees to indemnify and hold harmless the Board and its employees from any claim arising out of or related to the Registrant’s participation in the activity.

The Participant will at all times of participation be covered by a current accident/medical policy.

The Registrant’s participation in the activity is conditioned upon the Registrant complying with any and all federal, state, and Board rules and regulations, including but not limited to those related to health, safety, and/or the spread of contagious disease, including but not limited to COVID-19 and any related or derivative disease or condition and may be revoked at any time. The Registrant will comply with such rules and regulations at all times while present on Board property. Full Rules & Regulations listed here: https://drive.google.com/file/d/13sBeora7x8ij4EVmMzy563k1SsNjKlTy

By typing your name below, the undersigned Parent/Guardian and Participant acknowledge that they have read and understand the above terms and voluntarily accept them. This Agreement and Waiver shall remain in full force and effect unless withdrawn in writing by certified mail service to the Office of the Superintendent, 13701 Lake Ave. Lakewood, Ohio 44107, but under no circumstances shall it be withdrawn retroactively.