YMCA of Central Florida

YMCA of Central Florida Sports Pre-Registration

Sports



Page 1 of 3 - Participant Information


Please Select Your YMCA


Add up to 5 participants




DD/MM/YYYY











Actual practice days to be determined by the coach


Requests are filled on a first come first served basis and and not guaranteed.


YMCA of Central Florida | ymcacf.org  |  vers 11.28.18
YMCA of Central Florida
YMCA of Central Florida

YMCA of Central Florida Sports Pre-Registration

Sports

Page 2 of 3 - Parent/Guardian Information




Primary personal email address.

DD/MM/YYYY

(407) 555-1212











As a parent of a participant, would you like to volunteer coach?







(407) 555-1212



YMCA of Central Florida | ymcacf.org  |  vers 11.28.18
YMCA of Central Florida

YMCA of Central Florida Sports Pre-Registration

Sports

Page 2 of 3 - Parent/Guardian Disclosures

Code of Conduct

Acknowledgment of Receipt of Code of Conduct and Concussion Safety

I hereby acknowledge that I have received a copy of the YMCA’s Notice of Code of Conduct and YMCA's Concussion Safety for Parents and Athletes including its impact on my YMCA Membership. The effective date of the Notice is March 1, 2018.

I understand that the YMCA of Central Florida may need to change its policies including but not limited to its Code of Conduct from time to time. The YMCA of Central Florida commits to posting all material changes on our websites and update the “Effective Date” so that you will always know our policies.



YOUTH SPORTS

Athletics and Head Injuries – Informed Consent

The Y is the leading organization focused on youth development, healthy living and social responsibility. As a part of our mission your child’s safety is extremely important, so we’d like to take a few minutes to share with you information about the risks of head injuries and some new requirements under Florida Law for youth sports organizations.

During its 2012 regular season the Florida Legislature passed House Bill 291 to ensure that parents, coaches and athletes are informed of the risks associated with head injuries and to mandate minimum standards for  education, informed consent and reentry after suspected injury.

The law requires the following:

• Education of athletic coaches, officials, administrators, and youth athletes and their parents or guardians of the nature
and risk of concussion and head injury.

• The parent or guardian of a youth who is participating in athletic competition or who is a candidate for an athletic team to sign and return an informed consent each year before participating in athletic competition or engaging in any practice, tryout, workout, or other physical activity associated with the youth’s candidacy for an athletic team.

• Each youth athlete who has been removed from an activity may not return to practice or competition until the youth submits to the athletic coach a written medical clearance to return stating that the youth athlete no longer exhibits signs, symptoms, or behaviors consistent with a concussion or other head injury.

• Medical clearance must be authorized by the appropriate health care practitioner trained in the diagnosis, evaluation, and management of concussions as defined by the Sports Medicine Advisory Committee of the Florida High School Athletic Association.

Please sign and return the informed consent below to the YMCA staff. By signing below, I acknowledge that I have read this Consent Form. I have received information on Y related policies on concussions and I understand the risks of brain injuries associated with participation in athletic activity. I am aware of the requirements of the State of Florida’s House Bill 291 – Youth Athletes and elect to participate.



As one of the nation’s largest providers of youth and family programs, the Y long has made the safety of children and all vulnerable populations a top priority. Providing a safe, secure environment for members and participants begins with knowing who has access to YMCAs through membership, which underscores the important of membership screening. The YMCA conducts regular sex offender screenings on all members, participants, and guests. If a sex offender match occurs, the YMCA reserves the right to cancel membership, end program participation and remove visitation access.
Updated 06.31.18
Minor Participant Waiver
Minor Participant Waiver, Release and Indemnification of All Claims & Covenant Not To Sue

NOTICE: THIS IS A LEGALLY BINDING AGREEMENT. Read this document carefully and in entirety. By signing this agreement, you give up your right and the named minor’s right to bring a court action to recover compensation or obtain any other remedy for any personal injury or property damage however caused arising out of the named minor’s participation in the YMCA of Central Florida Programs, now or any time in the future.

NOTICE TO THE MINOR CHILD’S NATURAL GUARDIAN

READ THIS FORM COMPLETELY AND CAREFULLY. YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY. YOU ARE AGREEING THAT, EVEN IF THE YMCA OF CENTRAL FLORIDA USES REASONABLE CARE IN PROVIDING THIS ACTIVITY, THERE IS A CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLED BY PARTICIPATING IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN DANGERS INHERENT IN THE ACTIVITY WHICH CANNOT BE AVOIDED OR ELIMINATED. BY SIGNING THIS FORM YOU ARE GIVING UP YOUR CHILD’S RIGHT AND YOUR RIGHT TO RECOVER FROM THE YMCA OF CENTRAL FLORIDA IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THE ACTIVITY. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM, AND THE YMCA OF CENTRAL FLORIDA HAS THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM.

Acknowledgment of Risk

I, the parent/guardian in my legal capacity as the parent/guardian of the minor named below, do hereby acknowledge and agree that participation in the YMCA program activities comes with inherent risks. I have full knowledge and understanding of the inherent risks associated with the YMCA program participation, including but in no way limited to: (1) slips, trips, and falls, (2) encounters with nature including toxic plants and animals, (3) aquatic injuries, and (4) athletic injuries. I further acknowledge that the preceding list is not inclusive of all possible risks associated with the YMCA program participation and that said list in no way limits the operation of this Agreement.

Waiver, Release, Indemnification & Covenant Not to Sue

In consideration of my child's participation in the YMCA of Central Florida Programs, I the parent or guardian of the participant, agree to release and on behalf of myself and the minor named above, my heirs, representatives, executors, administrators, and assigns, HEREBY DO RELEASE the YMCA of Central Florida, its officers, directors, agents, employees, volunteers, and representatives from any causes of action, claims, or demands of any nature whatsoever including, but in no way limited to, claims of negligence, which I, the named minor, my heirs, representatives, executors, administrators and assigns may have, now or in the future, against the YMCA of Central Florida on account of personal injury, property damage, death or accident of any kind, arising out of or in any way related to the use of the YMCA of Central Florida facilities/equipment or participation in the YMCA of Central Florida programs whether that participation is supervised or unsupervised, however the injury or damage occurs, including, but not limited to the negligence of the YMCA of Central Florida, its officers, directors, agents, employees, volunteers, and representatives.In consideration of the named minor’s participation in the YMCA program, I, the undersigned parent/guardian of the named minor, agree to INDEMNIFY AND HOLD HARMLESS the YMCA of Central Florida, its officers, directors, agents, employees, volunteers, and representatives from any and all causes of action, claims, demands, losses, or costs of any nature whatsoever arising out of or in any way related to the named minor’s YMCA program participation. I hereby certify on behalf of myself and the named minor that I have full knowledge of the nature and extent of the risks inherent in the YMCA program participation and that I, on behalf of myself and the named minor, am voluntarily assuming said risks. I understand that I and the named minor will be solely responsible for any loss or damage, including personal injury, property damage, or death, the named minor sustains while participating in the YMCA program and that by signing this agreement I hereby, on behalf of myself and the named minor, release the YMCA of Central Florida, its officers, directors, agents, employees, volunteers, and representatives of all liability for such loss, damage, or death. I further certify that the named minor is in good health and has no conditions or impairments which would preclude his/her safe participation in the YMCA program.

In my legal capacity as parent/guardian of the minor, expressly agree, on behalf of myself and the named minor, that this document is intended to be as broad and inclusive as permitted by the law of Florida and that if any portion of the document is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. Furthermore, I expressly agree that this document shall be governed by and interpreted in accordance with the laws of Florida and that Florida shall have exclusive venue to hear any and all disputes relating to or arising from this document.

I further certify that my present age is of lawful age (18 years or older) and otherwise legally competent to sign this agreement, and that I have legal capacity to act as the parent/guardian of the named minor. I further understand that the terms of this agreement are legally binding and certify that I am signing this agreement, after having carefully read it, of my own free will. The foregoing written agreement represents the entire understanding between the parties. No oral representations, statements or inducement apart from the foregoing written agreement have been made.


Parent/guardian must list all registered participants (i.e. John Smith, Jane Smith)

Updated 08.31.18
Photo Release

YMCA of Central Florida Photo/Audio Visual/Narrative Release


EFFECTIVE APRIL 2018

I am 18 years of age or older. If not, my parent or legal guardian must consent and give permission on my behalf.

Consent.
For participation in activities to be conducted by the YMCA of Central Florida, consent must be provided, now and indefinitely, to the YMCA of Central Florida and collaborating third parties to make, reproduce, edit, broadcast or rebroadcast:
  • video film or footage of me (or my dependent child),
  • sound track recordings of me (or my dependent child),
  • photo reproductions of me (or my dependent child),
  • any narrative account of my (or my dependent child’s) experience
Consent gives permission to use the above materials for publication, display, sale or exhibition in promotions, advertising, education and legitimate business uses. Use includes unlimited and unrestricted reproductions in any form and media, adaptations and/or revisions created for YMCA of Central Florida use.

I understand and agree there may be no compensation for this, and I will not make any claim for payment of any kind. I may, or may not be, identified in such reproductions; however, my name will not be used to endorse any particular commercial products or commercial services.

Ownership, Confidentiality, and Shared Use.
With respect to any of the above uses, I further agree:
  • All uses shall belong to the YMCA of Central Florida and it may share them with others;
  • There is no obligation of confidentiality
  • YMCA of Central Florida and collaborating third parties will not be liable for any use or disclosure to a third party
  • YMCA of Central Florida shall exclusively own all known or later existing rights to the uses worldwide.
  • YMCA of Central Florida can use any video film, footage, sound track recordings and photo reproductions of me and/or my narrative account for any purpose and without compensation to me.
Release from Liability.
I agree that my consent is irrevocable. I hereby release and discharge the YMCA of Central Florida, its related parties and those it has given permission to use the above, from any and all claims, actions, lawsuits or demands of any kind arising out of my consent, the use, or the shared use of the above materials.


Parent/guardian must list the ages of all registered participants (i.e. 5, 10)

Release General Liability 


PHOTO / AUDIO VISUAL / NARRATIVE RELEASE OPT-OUT – GENERAL RELEASE FROM LIABILITY

My signature below serves as indication that I have declined to sign the YMCA of Central Florida’s photo, audio visual, and narrative release.

I am fully aware that the YMCA of Central Florida’s Code of Conduct contains provisions that prohibit all members, guests, and other individuals not in the direct employ of the YMCA of Central Florida or representing the interests of the YMCA of Central Florida from taking photographs or videos on the premises or inside the facilities of the YMCA of Central Florida at any time. Accordingly, I acknowledge that the YMCA of Central Florida cannot be responsible if an individual not in the direct employ of the YMCA of Central Florida or representing the interests of the YMCA of Central Florida captures my likeness in any way, shape, or form and I agree to release the YMCA of Central Florida from any claims, causes of action, or demands of any nature whatsoever, including, but in no way limited to, claims of negligence which I, my heirs, representatives, executors, administrators, and assigns may have, now or in the future, arising from or relating to an individual not in the direct employ of or representing the interests of the YMCA of Central Florida capturing my likeness, including, but in no way limited to, photos, videos, or audio recordings.

Furthermore, my signature below serves as my acknowledgment that, when the YMCA of Central Florida is taking official photos, videos, or audio recordings, the YMCA of Central Florida will be responsible for posting signage to that effect. By declining to sign the photo, video, and audio visual release, I agree to remove myself from any areas in which the YMCA of Central Florida is taking official photos, videos, or audio recordings and release the YMCA of Central Florida from any liability if I refuse to vacate said area.





YMCA of Central Florida | ymcacf.org  |  vers 11.28.18