Lobos Youth Clinic Registration

2180 Woodward St, Austin TX 78744

* are required items.

Lobos Youth Clinic Registration Form

If you are registering a child for our Youth Clinic, please complete the form with the data for the child.

First Name *

Last Name *

Date of Birth *

The date must be in the format MM/DD/YYYY

Gender *

Male

Female

Experience level

Beginner

Intermediate

Elite/Select club experience

Category

Phone *

Street Address

Line 1

Street Address cont.

Line 2

City

State

Zip Code *

Additional Information

Waiver and Release Agreement

I (or the parent or legal guardian of the minor child I'm registering), hereby give permission to participate in activities conducted by the Central Texas Lobos.
I certify that I (or my child) am physically fit such that I am able to participate and that I understand any rules and safety provisions established for this program. I hereby voluntarily release the Central Texas Lobos from any and all liability resulting from or arising out of my participation and/or receipt of instruction. I understand and agree that I am releasing not only the entities set forth above, but also the officers, agents, and employees of those entities. I understand and agree that this Waiver/Release will have the effect of releasing, discharging, waiving, and forever relinquishing any and all actions or causes of action that I (or my minor child) may have or have had, whether past, present or future, whether known or unknown, and whether anticipated or unanticipated by me or my minor child, arising out of participation and/or receipt of instruction except for the acts or omissions of the Central Texas Lobos, its officers, agents or employees which are found to be negligent by a court of competent jurisdiction. I understand and agree that I am assuming full responsibility for any and all risk of personal injury or property damage suffered by me and/or my minor child while participating and/or receiving instruction. I understand and agree that I am agreeing to release, indemnify, and hold harmless the Central Texas Lobos and their officers, agents, and employees from any and all liability or costs, including attorney fees, associated with or arising from participation and/or receipt of instruction. I understand that this Waiver/Release of Liability will be binding on me, my spouse, my heirs, my personal representatives, my assigns, my children, and any guardian ad litem for said children.
Medical Authorization
I hereby authorize the Central Texas Lobos and their coaches and instructors to perform first aid and child CPR, and to consent to any emergency medical treatment.

I Agree (required)

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