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WELCOME TO THE LEADING US TRAINING CENTER FOR SPRINGBOARD AND PLATFORM DIVING
 

 

 

Team Orlando Diving Registration

 

 
Diver Information
 
       
  First Name   Sex    
               
  Street            
  City   State
Zip
 
                 
  Home Phone  

Email

 
  Mobile Phone   Date of Birth
 
           
           
Guardian Information
           
           
    Mobile Phone
 
  First Name   Email
 
           
 

 
             
    Mobile Phone
 
  First Name   Email
 
           
           
           
Program Selection
           
  Summer 2009  
           
           
  To register for Team Orlando Diving without registering for a summer program, leave this section blank.
 

 

       
Unlimited Personal Release Agreement

 


Grant

For consideration which I acknowledge, I irrevocably grant to Team Orlando Diving and Team Orlando Diving Association, Inc. (together, "Company") and Company's assigns, licensees and successors the right to use through December 31, 2009 my/my child’s image and name in all forms and media including composite or modified representations in connection with the promotion, marketing and/or advertising of (i) Company and its business, (ii) the sport of diving and/or (iii) the YMCA and its programs (collectively, the “Permitted Use”). I waive the right to inspect or approve versions of my/my child’s image used for publication or the written copy that may be used in connection with any Permitted Use of the images.


Release

I release Company and Company's assigns, licensees and successors from any claims that may arise regarding any Permitted Use of my/my child’s image  including any claims of defamation, invasion of privacy, or rights of publicity or copyright. Company is permitted, although not obligated, to include my/my child’s name as a credit in connection with any Permitted Use of the image.


Company is not obligated to utilize any of the rights granted in this Agreement.


My E-Signature indicates that I have read and understood this agreement and I am over the age of 18. This Agreement expresses the complete understanding of the parties.

Both guardians must electronically sign this form if the diver is under the age of 18.

If you are not granting Team Orlando Diving use of your/your childs image and name as stated above, please complete the registration form but do not sign below.

 
           
         
  E-Signature   E-Signature
 
             

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