Participant Name *

First Name

Last Name

Participant Birthdate *

MM

DD

YYYY

Participant Cell Phone Number *

(###)

###

####

Participant Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact *

First Name

Last Name

Emergency Contact Cell Phone Number *

(###)

###

####

State Games of Michigan Waiver/Media Release Form *

I have read the State Games of Michigan waiver and by clicking below, I agree to the waiver as the participant OR parent/guardian of participant and that I am over the age of 18 years old View the State Games of Michigan waiver

I agree

Heads Up Concussion Waiver *

I have read the Heads Up Concussion waiver and by clicking below, I agree to the waiver as the participant OR parent/guardian of participant and that I am over the age of 18 years old View the Heads Up waiver

I agree

Communicable Diseases Waiver *

I have read the Communicable Diseases waiver and by clicking below, I agree to the waiver as the participant OR parent/guardian of participant and that I am over the age of 18 years old View the View the Communicable Diseases waiver

I agree

Refund Policy *

I have read the Refund Policy and by clicking below, I agree to the policy as the participant OR parent/guardian of participant and that I am over the age of 18 years old View the Refund policy

I agree