SARATOGA COUNTY DEPARTMENT OF AGING AND YOUTH SERVICES SPONSORS A DOUBLE DUTCH JUMP ROPE CLINIC

Youth from Saratoga County between the ages of 6 and 17 years old are eligible to participate in the Youth Month Event

Aging Double Dutch RegistrationForm

Please list any pertinent medical information (including those requiring maintenance meds)


Additional Information (not required but helpful information) IEP, Special needs, disabilities, physical limitations, aide required, anxiety, shy, etc.

Youth will need to bring a water bottle each day and a bagged lunch for days one and two. Pizza lunch will be provided on day three. Youth should wear comfortable, athletic clothing and sneakers. Remember you’ll be jumping in and out of rotating ropes, loose fitting clothing, long skirts, etc. will make participation difficult. Family and friends from the community will be invited to attend the skills demonstration and Double Dutch routine on day three from 2:00 pm – 3:30 pm.

PLEASE READ THE FOLLOWING CAREFULLY.  BY SIGNING BELOW, YOU AGREE TO THE FOLLOWING WAIVER.
I hereby grant permission for my child to participate in the Youth Sports and Sports Education – Double Dutch Jump Rope for Youth Month program.
I fully understand and acknowledge that there are inherent risks and dangers associated with my child’s participation in the Youth Sports and Sports Education Program. I also recognize the difficulties and challenges involved in indoor and outdoor sports and recreation programs, and that my child is sufficiently physically and psychologically fit to participate and has not been advised otherwise by a physician.
I agree to indemnify and hold harmless the County of Saratoga and businesses participating in the Youth Sports and Sports Education Program, its employees, and personnel from any and all claims, causes of action, liability for injuries or damages which may arise as a result of participating in this program, including but not limited to reasonable attorney’s fees and the costs and disbursement of any legal actions and extending to employees, personnel, volunteers, instructors, etc. in responding to any emergency and/or medical situation or event.
Furthermore, I understand that during the event photographs may be taken and published through social media pages or affiliated websites. Some photographs may capture your child’s participation, directly or indirectly. I grant permission to use photos taken which may involve my child for publication on said platforms.


Emergency Contacts

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