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Admissions
Academics
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Sports
APA Families
Calendars & Schedules
Support APA
Enhance
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yes, (If Date
Student Name:
*
First
Middle
Last
Current Grade Entering:
*
Kindergarten
First Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Last Grade Attended:
*
Kindergarten
First Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Last School Attended:
*
Please provide school name, city & state:
Current Age:
*
Date of Birth:
*
Step Up for Students Scholarships Accepted: (If scholarship has been approved and awarded please provide award letter or award ID number.)
*
SUSF-Florida Tax Credit Scholarship (FTC)
SUSF-Family Empowerment Scholarship with Unique Abilities (FES-UA) -https://www.stepupforstudents.org/scholarships/unique-abilities/
SUSF-Hope Scholarship
SUSF-PEP
NONE/Self Pay
Parent/Guardian Name
*
First
Last
Parent/Guardian Email
*
Shirt Size:
*
N/A
Youth Small
Youth Medium
Youth Large
Youth X-Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult 2XLarge
3XLarge
Do you have any known medical conditions?
*
Yes (If yes, please specify)
No
If yes, please specify:
Are you currently on any medications?
*
Yes (If yes, please specify)
No
If yes, please specify:
Do you have any allergies?
*
Yes (If yes, please specify)
No
If yes, please specify:
Permission & Agreement
*
I agree and give my permission
Consent and Agreement Form:
Acknowledgment of Risks By signing below, I acknowledge that participation in the APA Post Grad program involves athletic activities and other related events that carry inherent risks, including but not limited to physical injury, death, or other consequences. I am fully aware of these special dangers and risks and accept responsibility for them.
Certification of Information I certify that all information I have provided is accurate to the best of my knowledge. I further agree to inform academy officials, activity planners, coaches, and staff members of any physical or mental limitations that may affect my participation.
Assumption of Responsibility I accept full responsibility for my personal property and equipment used in connection with this activity. I understand that APA Post Grad, its insurance, or the facility hosting this event will not cover any risks or injuries associated with my participation.
Liability Waiver and Indemnification In consideration of my participation, I hereby release, indemnify, and hold harmless the APA Post Grad program, its staff, officials, and agents from any liability, claims, or causes of action arising out of or connected with my participation in this activity. This release extends to all risks, whether foreseen or unforeseen.
Photo and Likeness Authorization I authorize the APA Post Grad program official to use my or my child’s photo or likeness at their discretion for promotional purposes without additional compensation.
Medical Consent I authorize any medical personnel to treat any illness, injury, or other medical condition that may arise during my participation. I accept full financial responsibility for any medical costs incurred as a result of such treatment. Binding Agreement I have read and understand this release and indemnification agreement.
By signing, I acknowledge its binding nature upon myself, my heirs, representatives, successors, assigns, and administrators.
Please confirm your Consent and Agreement Form acknowledgment:
*
Multiple Items
*
Player Registration Fee -
$50.00
Please confirm your Fee Authorization Consent:
*
Submit
About
About Us
Admissions
Admissions
Academics
Academics
Athletics
Sports
APA Families
Calendars & Schedules
Support APA
Enhance