COVID-19 & Injury Waiver Signature * Player Participant Information   Select Level of Competition * Semi-Competitive Competitive   First Name * Last Name * Address * City * State Zip * Birth Date (Month Day, Year) * Ex. 10-12-2017 Current Grade School Attending *   Parent / Guardian Contact Information Parent First & Last Name * Parent cell phone # (include area code) * Ex. 816-123-4567 Parent E-mail Address * Parent #2, Cell Parent #2, E-mail   Other Information Provide any schedule requests or conflict information Requests filled ONLY AS AVAILABILITY ALLOWS!   Coach Requested (if none, type in "none") * Does your child have a buddy that they would like to be teamed with? If so, provide the "first and last" name of the buddy. (if none, type in "none") *   Once you have filled out the form to your satisfaction type in the following security code, then click Submit. NOTE that if you have inadvertently left out required information a red screen will appear, scroll up to see what you have missed, provide the response, then click the Submit button again. Security Code * Upper or Lower Case Letters Will Work *Click the Submit Button ONLY ONCE! Upon submission you be taken to our online credit card payment system provided by Groundwork. --- NOTE that you must have access to your e-mail to receive the code generated by Groundwork to initiate the payment process. --- Don't see the e-mail? Check your spam folder!