Academic Athlete Alliance, Inc.

Register for a program

Pick a session, tell us about your student, and complete the waiver, all in one place. It takes about five minutes.

1 Session 2 Student 3 Guardian 4 Health 5 Waiver

Before you register

Who: open to students in the grade range shown for each session.
Where: The Academic Athlete — 221 W. Philadelphia Street, Suite 12, York, PA 17401. Ample free parking.
Cost: our core programs are free or scholarship-first. [PLACEHOLDER: note any fee or "no cost".]
What to bring: [PLACEHOLDER: e.g., water bottle, notebook; a parent completes this form for students under 18.]

1 Choose your session(s)

Select one or more. Students may register for a single session or the whole series.

Please select at least one session.

2 Student information

Student full name *

Grade *

Date of birth *

School

T-shirt size (optional)

Anything we should know to help your student thrive?

3 Parent / guardian & emergency contact

Parent / guardian name *

Email *

Phone *

Home address

Emergency contact name *

Emergency contact phone *

Authorized for pickup (besides guardian)

4 Health & safety

Allergies (food, medication, other)

Medical conditions or medications we should know about

Physician / preferred hospital (optional)

I authorize The Academic Athlete Alliance to seek emergency medical care for my student if I cannot be reached, and I am responsible for related costs. *

5 Liability waiver & consents

Release of Liability & Assumption of Risk

I understand that participation in The Academic Athlete Alliance programs and activities may involve physical and other activities carrying inherent risks, and I voluntarily choose to have my student participate.

On behalf of myself and my student, I release, waive, and hold harmless The Academic Athlete Alliance, Inc., its staff, volunteers, mentors, and partners from claims for injury, illness, loss, or damage arising from participation, to the fullest extent permitted by law, except for gross negligence or willful misconduct.

I confirm my student is physically able to participate, or has been cleared to do so, and I have disclosed relevant health information above.

I agree that my student will follow program rules, staff instructions, and the Academic Athlete Code of conduct, and I understand a student may be removed for unsafe or disruptive behavior.

[PLACEHOLDER: replace with your organization's final waiver language reviewed by counsel.]

I have read and agree to the Release of Liability & Assumption of Risk above. *

I grant permission for photos/video of my student in program materials. (Leave unchecked to opt out.)

My student and I agree to the Academic Athlete Code. *

Type your full name as your signature *

Date *

Please complete the required agreements and signature.

We collect this information only to run the program safely and to contact you. We do not sell it, and we never publish personal contact details.

Browse Programs

Register for a program

Before you register

Release of Liability & Assumption of Risk

INFO@THEACADEMICATHLETE.ORG