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Active Duty Sponsor Information- Tell us about the active duty member in your family.

Please use normal formatting with proper upper and lowercase for entering names- ex: Joe Smith


(Ex: MM/DD/YEAR)



This email is for record keeping purposes only, you can opt-out of e-news below












Spouse or Partner's Information- Tell us a little bit about the other adult in your family. 

Please use normal formatting with proper upper and lowercase for entering names- ex: Joe Smith

Please use normal formatting with proper upper and lowercase for entering names- ex: Joe Smith


(Ex: MM/DD/YEAR)










Household Information- Tell us a little bit about your family.

This email address is linked to your individual or family membership. In the future you will use this email address to register for programs, events, and services.







Child(ren) Information




(Ex: MM/DD/YEAR)






(Ex: MM/DD/YEAR)






(Ex: MM/DD/YEAR)






(Ex: MM/DD/YEAR)






(Ex: MM/DD/YEAR)






(Ex: MM/DD/YEAR)






(Ex: MM/DD/YEAR)






(Ex: MM/DD/YEAR)






(Ex: MM/DD/YEAR)






(Ex: MM/DD/YEAR)



ASY Involvement Information- Tell us more about how you are involved or would like to be.



(If you only know the approximate year please enter Ex: 01/01/YEAR)



CONSENT TO PHOTOGRAPH, FILM, OR VIDEOTAPE FOR NON-PROFIT USE:

I hereby grant full permission for my myself, my child, and/or my family members to be photographed by the Armed Services YMCA San Diego staff for any legitimate purpose without payment or compensation.  I also hereby consent to the participation in interviews, the use of quotes, and the taking of photographs, movies or video tapes.  I also grant to the Armed Services YMCA San Diego the right to edit, use, and reuse said products for nonprofit purposes including use in print, on the internet, and all other forms of media. I also hereby release the the Armed Services YMCA San Diego and its agents and employees from all claims, demands, and liabilities whatsoever in connection with the above.

CONSENT AND RELEASE OF LIABILITY FOR PROGRAM PARTICIPATION:

I hereby voluntarily and knowingly assume all risks and dangers inherent and incidental to the activities of Armed Services YMCA programming for myself and my family members. I will not hold the Armed Services YMCA San Diego liable for any injuries incurred during programming or in transit to and from the program whether caused by equipment or the act or omissions of others excepting damage or injury solely caused by the willful misconduct or negligence of the Armed Services YMCA San Diego, or its employees, volunteers, or agents.  I do hereby authorize the Armed Services YMCA San Diego as agent for all Armed Services YMCA Members, to consent with respect to the minors, to any x-ray examination, anesthetic, medical, dental, or surgical diagnosis or treatment, and hospital care which is deemed advisable by, and is to be rendered under general or special supervision of, any physician and surgeon licensed under the provisions of the California Medical Practice Act on the medical staff of any hospital, whether such diagnosis or treatment is rendered at the office of the physician or at the hospital. I understand that the Armed Services YMCA San Diego is not responsible for costs incurred for medical care. If I participate in the program, whether as coach, instructor, aide, spectator, or participant, I presently waive as to the Armed Services YMCA San Diego and staff, officers and directors thereof, any claim presently known or

unknown for damage to property or personal injury whether caused by equipment or the acts or omissions of others including Armed Services YMCA San Diego personnel.

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