Fall 2025 Ruth Sports Volleyball Registration

Child's Name

First NameLast Name

Child's D.O.B

Age:

Grade:

Prounoun Prefference

She/HerHe/HimThey/ThemOther

Hispanic/Latino

YesNo

Race

Do you speak a language other than English at home?

YesNo

If yes, what is this language?

How well do you speak English (select one)?

Not at allNot wellWellVery well

In the past 12 months, has your family had difficulty paying for basic needs like food, housing, utilities, or transportation?

YesNoSometimes

What is the highest level of education you have completed?

Do you have a primary care provider (a regular doctor or clinic you go to for most of your healthcare needs)?

YesNoNot Sure

How safe do you feel in your neighborhood during the day and at night?

Very SafeSomewhat SafeNot Very SafeNot Safe at All

How often do you feel that you lack companionship, feel left out, or isolated from others?

OftenSometimesRarelyNever

Shirt Size:

Do you participate in any other programs offered by Timoteo Sports?

Are you interested in “More Than Sports”? (Check all that apply)

TutoringCollege Prep (2-year program, 4-year program)Career Development (School, Trade, or Vocational training)Volunteer OpportunitiesJoining the Military

Parent's Name

First NameLast Name

Phone Number

Please enter a valid phone number.

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Release & Liability

In Consideration of my/our child being allowed to participate in any way for the Ruth Sports program for the fall of 2025, it's related events and activities, the undersigned acknowledges, appreciates, and agrees that:

The risk of injury from the activities involved in this program is significant, including the potential risk for permanent paralysis and death, and while particular rules, equipment and personal disipline may reduce the risk, the risk of serious injury does exist; and

I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the releases or others, and assume full responsilbity for my participation; and I willingly agree to comply with the stated and customary terms and conditions for participation. If however, I observe an unusual and significant hazard during my presence or participation, I will bring such to the attention of the nearsest official immediately; and

I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, hereby release, indemnify, and hold harmless Ruth Sports, and it's officers, officials, agents and/or volunteers, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event, with respect to any and all injury, disability, death, or loss or demage to person or property, wheather arising from the negligence of the releases or otherwise, to the fullest extent by law.

I, the undersigned, hereby authorize the staff, representatives, or designated medical personnel of Ruth Sports to administer basic first aid and secure emergency medical treatment, including hospitalization, surgery, and/or medication, if necessary, for the above-named participant in the event of an accident, injury, or sudden illness while participating in Ruth Sports Volleyball.

I understand that every reasonable effort will be made to contact me (or the emergency contact listed above) before initiating such treatment. However, if I cannot be reached in an emergency, I grant permission for medical personnel to provide necessary treatment.

I acknowledge that Ruth Sports and its representatives are not responsible for any costs associated with emergency medical care. I further release and hold harmless Ruth Sports, its employees, volunteers, and affiliates from any liability or claims related to emergency medical treatment.

If a child leaves a practice or game for any medical reason, he or she cannot return without medical clearance from a physician. At any time, a coach can require medical clearance of a player to be able to participate or play at his/her own discretion.

Photo release statement: I also hereby consent, without further consideration or compensation, to use (full/partial) of all photos, audios or videos made of my child or family members during Ruth Sports sporting events, for the purposes of events documentation, promotional materials or web content. Further, I release Ruth Sports and its volunteers from any liability, which may arise from the use of those photos.

Emergency Contact Name

First NameLast Name

Emergency Contact Number

Please enter a valid phone number.

I have read this release of liability and assumption of risk agreement. I fully understand its terms. I understand that I have given up substantial rights by signing it, and sign it freely and voluntarily without any inducement.

Signature

My Products

Volleyball RegistrationAges(12-18)

$55.00

Total

$0.00

Payment Methods

Credit Card

Apple Pay

Cash App Pay