21 Elite - Student Athlete Registration Information

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Parents/Guardians must fill out.

Parent Full Name

Parent Information

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent Birthdate

YYYY

What sport(s) does your child play or want to play?

AIR21 BASKETBALL LEAGUE & RAPID21 VOLLEYBALL LEAGUE AIR21 Basketball is the 3v3 league is for both boys and girls from grades Kindergarten to 12th grade with emphasis on proper fundamentals such as Dribbling, Passing and Shooting. RAPID21 Volleyball League is an in-house club league for beginner to advanced players, GRADES 3-11 it is designed to introduce and develop all of the skills of the game in a fun and engaging environment. RAPID21 is a 3-hour program each week for athletes. Athletes are placed on teams based on age and skill level. The first hour focuses on skill training and the last 2 hours is team play. A great opportunity for learn and play!

Basketball

Volleyball

What services are you interested in?

21Fitness+ and 21Pro+ Geared to take your young athlete to next level of physical development. Most effective with skills training. 1. Specialized Nutritional Coaching & Tracking 2. Specialized Personal Training Coaching & Tracking 3. Personal Coaching via Email Communication 4. Video, Phone & Text Access 5. Monthly Detailed Reports 21Recruit+ Getting Started:  Recruiting can be a time consuming and confusing process.  Many parents don’t know where to begin or don’t have the time to make college contacts and tend to procrastinate when it comes to promoting their son or daughter.  The process starts in the prospect's early high school years and waiting until they’re a junior or senior is a devastating mistake many people make.  We will help keep you on track to give you the best opportunity to take your game to the next level. If you are a late starter, we can help put you on a fast track to improve your chances of playing in college. Recruiting Process Guidance Positive Academic Impact Assistance Creating Options Target Zone Creation Targeted Communication with College Programs Professional Video and Analytics Athlete Profile and Website Placement Exposure Team Guidance Post High School Services

Fitness & Nutrition Services (21Fitness+ & 21Pro+)

Recruiting & NIL Consulting Services (21Recruit+)

How did you hear about us?

Section 2: Student Athlete Information

Please only include one student-athlete per form.

Student Athlete Full Name

Student Athlete Information

First Name

Last Name

Student Athlete Birthdate

YYYY

Student Athlete Age

Student Athlete Gender

Student Athlete Height

Student Athlete Weight

Rate Your Child's Athletic Ability (Scale 1-10):

Rate Your Child's Skill Level (Scale 1-10):

Uniform & T-Shirt Signup

Is the size Youth or Adult?

School Name

School Grade

High School Graduating Year (if you do not know, put N/A):

School Coach Name: (Optional)

School Coach Phone Number: (Optional)

If you have multiple children that are interested, please fill out another form after completing this one, thank you.

Section 3: Youth Conditioning Assessment

Do you give this child permission to participate in a weight room? (ie lift weights)

Does the child participating have any allergies?

If yes, state details:

Has the child’s participating doctor ever said that they have a heart condition and that they should only perform physical activity recommended by the doctor?

Does the child participating feel pain in their chest when they perform physical activity?

In the past months, has the child participating had chest pain when they are not performing any physical activity?

Does the child participating lose their balance because of dizziness or do you ever lose consciousness?

Does the child participating have a bone or joint problem that could be made worse by a change in their physical activity?

Is the child participating doctor currently prescribing any medication for blood pressure or for a heart condition?

Do you know any reason the child participating should not engage in physical activity?

Has the child participating ever had pain or injuries (ankles, knee, hip, back, shoulder, etc.)?

Has the child participating ever had any surgeries?

Has a medical doctor ever diagnosed the child participating with a chronic disease, such as coronary heart disease, coronary artery disease, hypertension (high blood pressure), high cholesterol, or diabetes?

Is the child participating currently taking any medication?

Section 4: WAIVER & RELEASE OF LIABILITY FORM

Read fully: By participating in the sporting programs of 21 ELITE SPORTS TRAINING LLC and the facilities we conduct our services out of and requesting training during the period of the program, the Undersigned Participant expressly agrees and contracts, on behalf of its heirs, practitioners, consultants, insurers, executors, administrators, successors and assigns, that 21 ELITE SPORTS TRAINING LLC and the facilities we conduct our service out of and its employees, officers, directors, and associates, shall not be liable for any injury sustained during the period of the program or as a result of the use of 21 ELITE SPORTS TRAINING LLC and the facilities we conduct our services out of services, regardless of whether such injuries result, in whole or in part, from the negligence of 21 ELITE SPORTS TRAINING LLC and the facilities we conduct our services out of By the execution of this agreement, the Undersigned Participant accepts to get medical insurance and assumes full responsibility for any and all injuries, damages, and illnesses and hereby fully and forever release and discharge 21 ELITE SPORTS TRAINING LLC and the facilities we conduct our services out of, insurers, employees, officers, directors, and associates, from any and all claims, demands, damages, rights of action, or causes of action, present or future, whether the same be known or unknown, anticipated, or unanticipated, resulting from or arising out the use of services of 21 ELITE SPORTS TRAINING LLC and the facilities we conduct services out of. The Undersigned Participant expressly agree to indemnify and hold 21 ELITE SPORTS TRAINING LLC and the facilities we conduct our services out of harmless against any and all claims, demands, damages, rights of action, or causes of action, of any person or entity, that may arise from injuries or damages resulting from any injury. IN SIGNING THIS WAIVER & RELEASE OF LIABILITY, THE UNDERSIGNED PARTICIPANT ACKNOWLEDGES THAT I HAVE READ THE FOREGOING WAIVER AND RELEASE OF LIABILITY AND VOLUNTARILY EXECUTED THIS DOCUMENT WITH FULL KNOWLEDGE OF ITS CONTENT.

Electronic Signature (type full name)

Section 5: IMAGE RELEASE AGREEMENT

Read fully: I hereby grant irrevocable permission to 21 ELITE SPORTS TRAINING LLC and the facilities we conduct our services out of (“Organization”) to use photographs, videos, voice recordings and other media files (“Images”) of my child taken in publications, online, and in any other platform that 21 ELITE SPORTS TRAINING LLC and the facilities we conduct our services out of may deem fit to use in other communications related to the mission of the Organization. I also grant the Organization the permission to use my child's name or likeness in connection with the advertising, exploiting and/or any other purposes the Organization deems fit. I hereby fully and forever release and discharge the Organization, its insurers, employees, officers, directors, and associates, from any and all claims, demands, damages, rights of action, or causes of action, present or future, in connection with the use of Images. Parents and Guardians also have all rights to obtain any and all photographs, videos, voice recordings and other media files (“Images”). If you do not agree to this Image Release Agreement type "I do not agree".

Electronic Signature (type full name)

Any questions/concerns?

21 Elite - Student Athlete Registration Information

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