United We Pickle: After School Program Registration

SELECT SCHOOL: (All equipment provided by UWP)*

1. TX: Georgetown Christian Academy; Grades K-5th, every THURSDAY from 3:15-4:15pm, 9/19/24 - 11/21/242. NY: CATARACT Elementary School; Grades K-6th, every MONDAY from 3:30-4:30pm, 10/7/24-12/16/24. (School closed on 10/14 and 11/11. Make up classes on 11/25 and 11/26).3. NY: GERALDINE J MANN Elementary School; Grades K-6th, every TUESDAY from 3:30-4:30pm, 10/8/24-12/17/24.4. NY: HARRY F ABATE Elementary School; Grades 2nd-6th, every WEDNESDAY from 3:30-4:30pm, 10/9/24-12/18/24.5. NY: HYDE PARK Elementary School; Grades K-6th, every THURSDAY from 3:30-4:30pm, 10/10/24-12/19/24.6. NY: MAPLE AVENUE Elementary School; Grades K-6th, every FRIDAY from 3:30-4:30pm, 10/11/24-12/20/24.7. TX: RENAISSANCE ACADEMY; Grades K-6th, every WEDNESDAY from 3:45-4:45pm,Other

Child's Name*

First NameLast Name

Child's D.O.B*

Age:*

Gender:*

Additional Children's Information

Name(s), age(s), gender(s)

Other

Any allergies or other information we need to know?

Shirt Size:

Parent's Name*

First NameLast Name

Phone Number*

Please enter a valid phone number.

Email*

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Emergency Contact Name*

First NameLast Name

Emergency Contact Number*

Please enter a valid phone number.

Pick-Up Instructions:*

Waiver, Release & Liability

In Consideration of your child(ren) being allowed to participate in any way for the Pickleball program for the 2024/2025 season, it's related events and activities, the undersigned acknowledges, appreciates, and agrees that:

As the parent or legal guardians, you acknowledge that your child is medically cleared for participation in pickleball instruction. We emphasize that participation in athletic activities inherently involves risks. By submitting this enrollment, you assume full responsibility for medical expenses incurred as a result of any injuries sustained during instruction.

In the event of an emergency where you cannot be immediately contacted, you authorize United We Pickle coaches, EMT, hospital staff or any other qualified professional to provide necessary medical treatment to your child.

Financial Provisions:

In consideration of the substantial investments in equipment, facilities, and professional instruction, all enrollments are irrevocable and non-refundable upon payment.

We maintain an unwavering stance against any form of misconduct or abuse. Should your child recurrently exhibit disciplinary concerns necessitating their removal from the program, refunds will not be issued.

In the exceptional circumstance that classes are canceled due to unforeseen events beyond our control, such as inclement weather or school closures, we will endeavor to reschedule make-up classes with the school’s cooperation. Conversely, if classes are canceled due to our own operational factors, we will promptly provide make-up opportunities. If the addition of make-ups due to operational factors is not feasible, a credit will be applied to your account.

You further agree to protect and indemnify United We Pickle LLC and their pickleball coaches from all liabilities, costs, and expenses arising from your child’s participation.

Photo release statement:

You also hereby consent, without further consideration or compensation, to use (full/partial) of all photos, audios or videos made of your child(ren) or family members during United We Pickle LLC sporting events, for the purposes of events documentation, promotional materials or web content. Further, you release United We Pickle LLC, coaches and its volunteers from any liability, which may arise from the use of those photos.

I have read this release of liability and assumption of risk agreement. I fully understand its terms, and sign it freely and voluntarily without any inducement.

Signature

Pickleball Program/ Products*

Registration

$247.00 Quantity
Item subtotal:$0.00

Selkirk Paddle

$49.97 Quantity
Item subtotal:$0.00

Enter coupon

Subtotal

$0.00

Tax

$0.00

Shipping

$0.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

SPONSORS & PARNTER DISCOUNT LINKS:

SELKIRK website link and discount code:
(At Checkout, enter Code: ADV-LBLAAKMAN)

TOPSPIN PRO website link and discount code:

BLAZEPOD website link and discount code:

KANGEN WATER website link

Register Below

ABOUT US & OUR PROGRAM:

PARTICIPATING SCHOOLS: