THIS SECTION MUST BE COMPLETED IN FULL

If this is the first time this person has registered to
Participate in a Sulphur Parks & Recreation sports program,
please check this box.

What is the player's current age?___ Today's date______

Player's full name________________________________

Player's Social Security Number_______________________

Player's Birthdate__________ Player's sex (M or F)____

Street address_______________________________________________
__________________________________________________________
Home Number ____________________ Work Number____________________

If the player participated during last year's season for this sport, what was the name of the team (or coach)?_____________________________________

Playing age is determined by the age of the child on July 31 of the year in which the sport is played (exceptions: Youth Baseball the cutoff date is May 1, and Youth Softball the cutoff date is January 1 the year in which the sport is played)

I do hereby certify that all information on this form is correct and that Sulphur Parks and Recreation (SPAR) and its paid and volunteer workers will not be held responsible for any injury to the registered player while participating in the recreation program at any facilities scheduled for use by SPAR or during transportation to said facilities. Registrants are responsible for arranging their own transportation to all activities and assume all liabilities related to said transportation. I further understand that SPAR does not provide health insurance coverage for accidents or injuries that occur as a result of participation in or use of its facilities. Registrants who have missed one or more practices or games due to serious injury or disease, must provide SPAR with a doctor's release before returning to participate. All persons participating in SPAR sponsored activities and/or on or using SPAR owned properties/facilities agree to conduct themselves according to SPAR's standards for behavior and abide by any and all disciplinary actions imposed by SPAR. This release is valid for all SPAR sponsored programs until revoked in writing.

Participant's signature (if player is 18 yrs. old or over) or Parent or Guardian's signature (if player is under 18 yrs. old)

________________________________  Date:______________