After School Program

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Liability Waiver

1.	The risk of injury from the activities involved in the program is significant, including the potential for serious personal injury, and while particular rules, equipment and personal discipline may reduce this risk, the risk of serious injury does exist; and,

2.   I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the Releasees (as defined below) or others, and assume full responsibility for my participation; and,

3.   I, for myself and on behalf of my heirs, assigns, personal representatives and next to kin, hereby release and hold harmless, Full Moon Academy, their officers, officials, agents and / or employees, other participants sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event (“Releasees”), with respect to any and all injury, disability, death or loss or damage to person or property, whether arising from the negligence of the Releasees, or otherwise; and,

4.   I willingly agree to comply with the stated and customary terms and conditions for participation. If however I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,

5.   I willingly agree to comply with all rules and regulations set by Full Moon Academy.

I have read this release of liability and assumption of risk agreement and fully understand its terms.  I also understand that I have given up certain rights by signing it, as described above, which I agree to do voluntarily.

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I have read and agree with the Liability Waiver

Photo Release Waiver

I understand that participants, including myself and my child, in Full Moon Academy functions may be included in photographs and/or videos (the “Photos”) taken by spectators, parents, coaches, staff members, and/or by professional photographers.
 
Accordingly, I give Full Moon Academy (and their designees, if applicable) the right to use the Photos as well as my name, my child’s name (first names only), and likeness in any manner and without any compensation to me or my child. I waive any right to inspect or approve the final version of the Photos and/or any accompanying written materials, such as a description of the applicable Photo.
 
Examples of how Full Moon Academy uses the Photos include on social media, in e-mail marketing, on printed marketing materials, on the Full Moon Academy website, on signage, and on other materials used to promote the Full Moon Academy brand.
 
I represent that I am a parent/legal guardian to my child, who is a participant, and I agree that the grant and release explained above binds me and my child to all of its terms.
 
I have read this photo release and fully understand its terms.  I also understand that I have given up certain rights by signing this release, as explained above, and I voluntary agree to do so.

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I have read and agree with the Photo Release Waiver

Concussion Waiver

While Full Moon Academy programs involve minimal contact and the risk for concussions in our programs is low, we ask that you read and acknowledge that you understand our concussion safety policy below.

What is a Concussion?

A concussion is a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells.

The CDC estimates as many as 3.8 million concussions occur in the U.S. annually through sports and recreational activities.
 
The Facts	 	Recognizing a Possible Concussion
1. A concussion is a brain injury.
2. All concussions are serious.
3. Concussions can occur without loss of consciousness.
4. Concussions can occur in any sport.
5. Recognition and proper management of concussions when they first occur can help prevent further injury or even death.
	 	To help recognize a concussion, you should watch for the following two things among your athletes:

1. A bump, blow, or jolt to the head or body that results in rapid movement of the head.   
2. Any change in the athlete’s social or emotional behavior, thinking or remembering, physical or sleep functioning.  You may notice signs before the athlete does.
 
Recognize the Signs and Symptoms!
PHYSICAL
•	Bothered by light or noise
•	Dizziness or balance problems
•	Feeling tired, no energy
•	Headaches
•	Nausea or vomiting (early on)
•	Vision problems	THINKING OR REMEMBERING
•	Attention or concentration problems
•	Feeling slowed down
•	Foggy or groggy
•	Problems with memory (short or long-term)
•	Trouble thinking clearly	SOCIAL OR EMOTIONAL
•	Anxiety or nervousness
•	Irritability or easily angered
•	Feeling more emotional
•	Sadness	SLEEP
•	Sleeping less than usual
•	Sleeping more than usual
•	Trouble falling asleep

For more information on concussions, please visit cdc.com/heads-up or concussionfoundation.org.

Full Moon Academy “When In Doubt, Sit Them Out” Policy:
An athlete who is suspected of sustaining a concussion or head injury will be removed from the practice or game immediately and will not be allowed to return to play without written clearance from a licensed health care provider. The player should not be left alone, and the parent/guardian will be notified to follow up accordingly.

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I have read and agree with the Concussion Waiver

Registration Agreement

As a parent/legal guardian to the participant and in consideration of being allowed to participate in any way in the Full Moon Academy related events and activities, I agree and understand the following:
•	All deposits and fees are non-refundable under all circumstances.
•	There are no guarantees to the number of games or amount of time the participant will play.
•	I understand that the chief goal of Full Moon Academy is for me and my child to have an outstanding experience. If it does not deliver the Full Moon Academy Experience as outlined when I registered, I will notify the local Full Moon Academy Program Director of my issue/concern in writing as soon as possible so that he/she may have the opportunity to satisfy me.
•	I further understand that Full Moon Academy will not reserve a place for any child on a schedule or team until full payment has been made.
I will follow all rules, regulations and bylaws set by Full Moon Academy, and their respective assigns, licensees and legal representatives. I have read this registration agreement and fully understand its terms.  I also understand that I have given up certain rights by signing it, as described above, which I agree to do voluntarily.

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I have read and agree with the Registration Agreement

I want to volunteer - Myself

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NOTE: You will be automatically assigned to your child’s team (unless you request otherwise).

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