Billing Address*

City*

State*AlabamaAlaskaAmerica SamoaArizonaArkansasArmed Forces AmericasArmed Forces EuropeArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandVirginiaWashingtonWest VirginiaWisconsinWyoming

Postal code*

Participant Birthday*

Participant Gender* FemaleMaleNon-BinaryPrefer not to say

Participant School Level* ElementaryMiddle SchoolHigh SchoolCollegeNot currently enrolled

How did you hear about this event? I was a previous participtantSibling was a previous participtantFlier or HandoutWord of mouthAYU social mediaAYU newsletterAYU web siteUSAU website/social media/newsletterCommunication from coachOther

Any dietary restrictions?

Participant USA Ultimate ID

Please select one* Participant is a 2019 USAUltimate memberParticipant has a USAUltimate number but doesn't have 2019 membershipParticipant has never been a USAUltimate memberNot sure/other

This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to indemnify and hold harmless the releasees from any and all liabilities incident to my minor child’s involvement or participation in these programs above, even if arising from their negligence, to the fullest extent permitted by law.
By clicking 'Yes' below you are consenting to the USA Ultimate waiver. This means you won't need to complete this form on-site or bring the completed USA Ultimate Waiver to registration. You do still need to have the participant bring the completed USA Ultimate Medical Authorization form to the clinic -- this form will also be provided in the confirmation email you will receive after registering. Yes*

Name/Relationship*

Email*

Phone*