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Sports Application

Sex
Any Health Related Issues?
Do you live in the city limits of MZ

I authorize such physicians or medical staff as the Mount Zion Recreation Department may designate to carry out any medical treatment including
emergency room treatment or hospital cares which may be necessary. I further authorize the hospital and its medical staff to provide medical
treatment deemed necessary by them. It is understood that I will be contacted by telephone, if possible, for instruction. The physicians, organizers,
officers, director, agents and employees of Mount Zion Recreation Department as well as the City of Mount Zion are hereby released, acquitted and
discharged from any claim of damage during the event or program.

 

I, the parent or guardian, of the above named minor do hereby give permission for them to participate in the above named program under the
direction of the Mount Zion Recreation Department. It is my understanding that participants in these activities will be assigned to teams without
regard to their personal transportation needs. I UNDERSTAND THAT MOUNT ZION RECREATION DEPARTMENT IS NOT RESPONSIBLE
FOR THE TRANSPORTATION FOR ANY PARTICIPANTS IN OUR PROGRAMS. I take full responsibility for the return of any equipment,
uniforms, etc. that is the property of the Mt. Zion Recreation Dept. that is assigned to my child. No rowdiness, profane language or display of un-
sportsmanlike conduct will be tolerated from players, spectators, parents or coaches. Anyone failing to comply will be asked to leave the facility.

Upload Child's Birth Certificate

Birth Certificate is needed for every sport. If you are not able to upload a picture of it here then you can email them to chad@cityofmountzion.com or text to 470-277-0626.

Thank You. Thank You. CALL IN THE NEXT 24 HRS OR YOUR APPLICATION IS VOID

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