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CATHOLIC YOUTH MINISTRY
DIOCESE OF WILMINGTON
ST. MARY MAGDALEN PARISH
ATHLETIC REGISTRATION FORM

Sport:  ______________________________

Name of Participant:  ________________________________________

Address:  ____________________________________   

Development:  __________________

City:  ___________________   State:  ______  Zip:  __________   Phone:  ______________

Date of Birth:  _____________  School:  ____________________________   
Grade (during season):  _____  

Email Address (parent/guardian): _________________________________

Are you registered with a Diocese of Wilmington Parish:   Yes  /  No   (Circle One)

If yes, which Parish: _________________________________________________________

Do you participate in any other activities during the season?   Yes  /   No   (Circle One)

Other Activities:  ____________________________________________________________

Could these activities conflict with this CYM activity?  Yes  /  No  (Circle One)

Please explain:  _____________________________________________________________

CYM rules prohibit individuals in 8th grade through 12th grade from participating on a CYM parish team and any high school team (Freshman, JV, Varsity. etc.) in the same sport.  I hereby give my consent for the above named individual to participate in CYM athletics during the current program year.  I recognize that there are certain risks of physical injury in playing competitive athletics.  Excluding intentional, deliberately inflicted and illegally caused injuries, I further agree, in consideration with CYM’s sponsorship of beneficial athletic competition, to release the office of the Catholic Youth Ministry of the Diocese of Wilmington, the Catholic Diocese itself, the St. Mary Magdalen Parish, and all of their employees, directors, administrators, coaches, and staff from all legal liability for accidental injuries suffered by my child as a result of participation in athletic activities, or travel to and from any athletic event.  Providing, however, that recourse is reserved to seek damages, medical and hospital expenses, and court costs for any such accidental injuries to my child incurred during a scheduled event from any liability insurance carrier within the limits of its liability policy.  I affirm that the information above is true and correct.  I agree to complete the online CYM registration, providing additional medical information as required.  

Signature of Parent/Guardian:  ________________________________________________

Relationship to Participant:  ____________________________  Date:  ________________