Panthers
Registration Form
First Name
Last Name
Address
City
State
Home Phone
Email
Parent's Name
Cell Phone
Grade
Age
The participant assumes all risks associated with participation in the program; the Panthers
assume no liability for injury or damages arising from participation in the program. Due to the
strenuous nature of some activities, the Panthers encourage each participant to consult his or
her physician concerning fitness to participate in the program. The participant consents to
emergency treatment. The participant also consents to the Panther’s use if any photographs
taken or video tapes made of the program. If the participant is a minor, the parent or guardian
approves his or her participation in the program.
