LANCASTER COUNTY SPORTSMEN FOR YOUTH

YOUTH FIELD DAY REGISTRATION AND

RELEASE FROM LIABILITY FORM

Youth must be at least age 10 and no older than age 15 by day of event.

    The following form is to be completed by the parents or guardian of the youth who will be participating in the Youth Field Day, held at Southern Lancaster County Farmers Sportmens Association on Saturday, June 2, 2012.

Youth’s Name______________________________________________ Age ______  Sex ____

Date of Birth__________________           T-Shirt Size (men’s sizes only)    M       L      XL

Parent’s Name___________________________________________  Home Phone _________

Parent’s Address_______________________________________________________________

            City_______________________________   Zip Code________________________

Parent’s Email Address__________________________________________________________
                                    (registration can be confirmed by email)

I/We, the undersigned parent or guardian, do hereby permit my/our child to participate in the activities offered by the Lancaster County Sportsmen for Youth Field Day event, held at Southern Lancaster County Farmers Sportmens Association on June 2, 2012 at his/her own risk.

I/We, the undersigned parent or guardian, do hereby release Lancaster County Sportsmen for Youth,Southern Lancaster County Farmers Sportmens Association, and the sponsors and staff members of the Youth Field Day event from any liability due to any accident or injury incurred during the activities.

I/We, the undersigned parent or guardian, give permission to Lancaster County Sportsmen for Youth to use any incidental photos of family members to advertise future events.

____________________________________            ____________
(signature of parent or guardian required)          (date)

MAIL COMPLETED FORM TO THE ADDRESS ABOVE BY MAY 26, 2012

HAVE YOU EVER ATTENDED A YOUTH FIELD DAY BEFORE?                         YES/NO