COVID-19 & Injury Waiver Signature * Today's Date *   Player First Name * Last Name * Player Birth Date (Month, Day, Year) * Current Age * Grade as of September 2021 * 4th 5th 6th 7th 8th Name of School * Player Height * Player Position *   Parent / Guardian Contact Information Parent / Guardian Name * Address * City * State * Zip * Cell Phone -- Ex: xxx - xxx - xxxx * Include area code E-mail * Parent #2 Name Parent #2, Cell * Parent #2, E-mail   Security Code * When applying, upper or lower case letter entry will work. Once you have filled out the form to your satisfaction click SUBMIT. Your info will be sent to us and you will be taken to our online payment system provided by GroundWork. Click the Submit Button only once; do not double click. If, on clicking Submit, you get a RED screen - scroll back up to review; you have inadvertently failed to provide information in a "required" field(s).