This information is required for tracking and grant funding purposes. All information will be kept confidential and will not be used in any identifying way to outside organizations.

Release of General Liability I agree to accept any liability for personal injury arising out of my student's participation in athletic, academic and mentoring activities of Crossover Mission. I understand and acknowledge that Crossover Mission, Inc. is a community supported, 501(c)(3) organization, and I agree it is not a commercial activity. Release of Liability I am the parent/guardian of of the student listed above who is participating in the basketball training and academic mentoring program offered by Crossover Mission, Inc. Vero Beach, FL, and held at the Crossover Center, School District of Indian River County and other contracted facilities. I do understand that participation in this sporting activity is potentially dangerous and serious injury may occur. I hereby release any claim of any nature which I or my minor student might have against Crossover Mission, Inc. its officers, agents, employees, volunteers and the School District of Indian River County from any and all liability for any injury incurred during this program or incurred while being transported by automobile by a Crossover Mission staff member, tutor, coach, mentor or volunteer. I attest and verify that I have full knowledge and understanding of any and all risks involved in such participation, and that I will, on behalf of the named student, assume full responsibility for such risks and pay any and all medical, emergency, and other costs.

I hereby authorize the staff of Crossover Mission, Inc. to communicate with my student for appropriate purposes, using, but not limited to, email, text, cell phone, and other social media.

As parent/guardian, I understand that I will be part of the goal setting process for my student, and I will allow my student's school to release relevant educational information regarding my student to the tutors/mentors of Crossover Mission, Inc. for academic assistance. I give authorization for my student to be transported by authorized members of the Crossover Mission, Inc. organization for academic support and training purposes. I allow Crossover Mission access to school academic portals. Included in that is the Indian River County School District FOCUS portal, St. Edward's Student Academic Portal, Florida Virtual Portal, Homeschool Academic Portals and plans, and any other programs aimed at improving academic performance within the school district. These online tools provide updates on my student's performance and are necessary for effective and meaningful, weekly academic mentoring. In order to provide access to the electronic portals/gradebooks by the Crossover tutors/mentors, I provide Crossover Mission with the separate release forms. All information is kept strictly confidential by Crossover Management.

I, the undersigned, as parent/guardian of the named student, hereby authorize the staff of Crossover Mission, Inc. and its sponsors and vehicle drivers as my agents, to consent to medical, surgical, dental examination or treatment, and/or care at any hospital or by licensed medical personnel in the event of emergency. All information is kept strictly confidential by Crossover Management.

All parent/guardians of Crossover participants are required to volunteer for one event each school year. Please select the volunteer activities that interest you.

A fee of $100 per student/per per program is due to participate in Crossover Mission. This fee includes the Crossover Mission basketball uniform. Throughout the year, there may be additional opportunities for student athletes to participate in the competitive AAU travel basketball seasons or for away events or camp experiences. These opportunities are optional, earned and will have additional fees.