Quentin Snider Skill Sessions Signup Form
Please choose a session, fill out the form below, and sign the waiver before submitting payment
Choose Session Night
*
Session 1 - Tuesday June 16th 5th-8th Grade 6-7 PM
Session 2 - Tuesday June 16th 9th-12th Grade 7-8 PM
Session 3 - Thursday June 18th 5th-8th Grade 6-7 PM
Session 4 - Thursday June 18th 9th-12th Grade 7-8 PM
Participant Name
*
First Name
Last Name
Parent Name (If Child Is Under 18)
First Name
Last Name
Email
*
example@example.com
Emergency Contact Name
*
First Name
Last Name
Emergency Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Age Group
*
Please Select
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Brief Health Note
Participation Agreement
PARTICIPATION AGREEMENT: (Please Read Before Signing) The risk of injury to my child from the activities involved in these programs is significant, including the potential for permanent disability and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and, 1) FOR MYSELF, SPOUSE, AND CHILD, 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 responsibility for my child's participation; and, 2) I willingly agree to comply with the program's stated and customary terms and conditions for participation. If I observe any unusual significant concern in my child's readiness for participation and/or in the program itself, I will remove my child from the participation and bring such attention of the nearest official immediately; and, 3) I myself, my spouse, my child, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Quentin Snider Skill Sessions LLC, as well as, directors, officers, officials, agents, employees, volunteers, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and leasers of premises used to conduct the event, WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property incident to my child's involvement or participation in these programs, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law. 4) I, for myself, my spouse, my child, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY INDEMNIFY AND HOLD HARMLESS all the above Releases from any and all liabilities incident to my involvement or participation in these programs, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent permitted by law. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
Signature
*
I have read the waiver
*
I have read the waiver
My Products
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Session 1 - Tues June 16th Grades 5-8 6-7PM
$25.00
$
25.00
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Session 2 - Tues June 16th Grades 9-12 7-8PM
$25.00
$
25.00
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Session 3 - Thur June 18th Grades 5-8 6-7PM
$25.00
$
25.00
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Session 4 - Thur June 18th Grades 9-12 7-8PM
$25.00
$
25.00
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Test
$5.00
$
5.00
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Payment Methods
Choose from one of the PayPal options to
make your payment.
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