2. 
   
   
3. 
   
   
5. Player Information
7. Player Last Name*
8. Player Middle Name
9. Player First Name*
10. Player Suffix
12. Birth Date*
13. Age as of July 31st of this year*
15. Address*
16. Apartment Number
18. City
19. State*
20. Zip Code*
22. Team Name*
24. In Case of Emergency Call
26. Emergency Contact Name*
28. Emergency Contact Phone*
30. Emergency Contact Relationship to Player*
32. Medical Information
34. Illness/Allergies
36. Medications
38. Special conditions/concerns:
40. Parental/Guardian Permission and Waiver
42. By my signature below, I, the parent or guardians of the above-named participant, give my permission for him/her to participate with Shreveport Public Assembly & Recreation (SPAR). I hereby swear and attest that the above-named child is physically fit and has no medical reasons which would prevent him/her from safely participating in the current SPAR. Furthermore, I hereby acknowledge that it is my responsibility to inform my child’s coach or SPAR Athletic Division staff, in writing, if there is any change in the medical condition of my child. I also understand that it’s my responsibility to obtain written permission from my child’s physician on official medical stationary in order to seek permission for my child to resume participation after any and all such injury, illness or accident.
    
    I acknowledge that I am fully aware of the potential dangers of participating in any sport and I fully understand that participating may result in any injuries, paralysis, permanent disability and/or death. Therefore, I do hereby, for the above-named participant, agree to indemnify, defend and hold harmless the City of Shreveport, its elected officers, employees, sponsors and agents against any and all claims, demands, suits, damages and expenses that may arise out of or in connection with the purposes stated herein. I also agree to provide a certified birth certificate of the above-name which will be kept on file at the SPAR Athletic Office.
44. SPAR Adult Code of Conduct
46. Any adult who is using alcohol, tobacco and/or appears intoxicated at a SPAR Youth game/event, and/or who is flagrantly rude, attempts to intimidate, verbally abuse, taunts, ridicules, throws objects and/or uses vulgarity or profane language/gestures with an official, coach, volunteer, staff member, participant or other event attendee shall be asked to leave the event premises and subject to be permanently banned from all SPAR Youth League events. Any adult who physically assaults an official, coach, volunteer, staff member or participant or threatens bodily harm shall be permanently banned from all SPAR Youth Athletic events and prosecuted to the fullest extent of the law.
48. Rules and Regulations: By my signature below, I hereby stipulate that I have read, fully understand and voluntarily agree to all of the above:
49. I give the City of Shreveport permission to photograph my child/myself for the purpose of publicizing events and/or programs. *

    1. Yes
50. I have the read the SPAR Parental Code of Ethics and my initials will serve as verification that that I will adhere to them accordingly *

    1. Yes
52. Waiver of Liability Release Form
54. I hereby agree to indemnify, release, defend, and hold SPAR and the City of Shreveport, and all of its members, officers, agents and employees, both paid and voluntary, hereinafter referred to as “RELEASEES”, harmless of and from any and all liability, claims, suits, or cause(s) of action which may arise, regardless of whether caused by the negligence of RELEASEES, from bodily injury, death or property damage, to me, or my children, or to third persons as a result of my, or my child’s, participation in the activities. I have been fully advised to the terms of the event and hereby agree to perform and consent to my participation, as well as my child’s participation, in the activities. I release RELEASEES from any claim whatsoever on account of first aid, treatment, or service rendered to me or my children during participation in the activities. I give SPAR and the City of Shreveport permission to photograph my child or myself for the purpose of publicizing events and/or programs. The terms of this release are contractual and not a mere recital.
56. SPAR EVENT PARTICIPANT/SPECTATOR COVID-19 WAIVER
58. In consideration of being permitted to participate in SPAR or other City related activities; I and the City, agree as follows:
    In consideration of being allowed to participate and/or spectate in any way in the Shreveport Public Assembly and Recreations sports programs, related events and activities, the undersigned acknowledges, appreciates, and agrees that:
    
    1. The risk of injury and/or illness from the activities involved in the program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce the risk, the risk of serious injury does exist;
    
    2. The risk to have contact with individuals, who have been exposed to and/or have been diagnosed with one or more communicable diseases, including but not limited to COVID-19 or other medical conditions, diseases, or maladies does exist, and it is impossible to eliminate the risk that I could be exposed to and/or become infected through contact with or close proximity with an individual with a communicable disease;
    
    3. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume all full responsibility for my participation;
    
    4. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and
    
    5. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS THE CITY OF SHREVEPORT, their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of the premises used to conduct the event ("Releasees"), WITH RESPECT TO ANY AND ALL INJURY, ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.
    
    6. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, BEFORE ACKNOWLEDGING THE CHECKBOX BELOW, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY AGREEING TO IT ON MY OWN BEHALF OR ON BEHALF OF THE YOUTH PARTICIPANT ASSOCIATED WITH THIS GUARDIAN ACCOUNT, AND I SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
    
    
    ACKNOWLEDGEMENT BY ADULT PARTICIPANT: By acknowledging and agreeing to the checkbox below, I agree and verify the following:
    1) I consent and agree to assume the risks of participation in these programs; and
    2) that I specifically agree to the release as provided herein of all the Releasees, and, for myself, my heirs, assigns and next of kin, I release and agree to indemnify the Releasees from any and all liabilities incident to my involvement or participation in these programs EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.
    
    
    ACKNOWLEDGMENT BY PARENTS AND/OR LEGAL GUARDIANS OF YOUTH PARTICIPANTS (if completing form on behalf of a minor): By acknowledging and agreeing to the check box below, I agree to and verify the following:
    1) I am the parent or legal guardian for the youth participant associated with this guardian account,
    2) that the date of birth of the youth participant associated with this guardian account is correct,
    3) that as parent/legal guardian with legal responsibility for this youth participant, I consent and agree to assume the risks of his/her participation in these programs; and
    4) that I specifically agree to his/her release as provided herein of all the Releasees, and, for myself, my heirs, assigns and next of kin, I release and agree to indemnify the Releasees from any and all liabilities incident to this youth participant's involvement or participation in these programs as provided above EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.
60. 1. Agree to all
62. Parent or Guardian Signature*
64. Date*
66. Parent Email Address*
Leave This Blank:


67. 1. Receive an email copy of this form.
68. Email address

    This field is not part of the form submission.

69. Submit

* indicates a required field