Top'Hand in Hand' Participant Registration

Top'Hand in Hand'

#PlayItForward
Participant Form
Player name*
Player Birthdate*

MonthDayYear
Date
Player Gender*
Parent Name*
Parent email*
example@example.com
Parent phone number*
Second Parent Name
Second Parent email
example@example.com
Second Parent phone number
Location (ex. Roanoke Rapids)*
Health Information:
Primary Disability/Condition: *
This helps provide us a better understanding of the child's needs for accommodations and support.
Secondary Disability/Condition (if applicable)
Level of Support Needed: *
Does the athlete have any medical conditions or allergies that we should be aware of?*
If yes, please explain:
Does the athlete have seizures or other health concerns we need to be aware of?*
If yes, please explain:
Does the athlete have any mobility/movement limitations? *
If yes, please explain:
Does the athlete require any specialized equipment (e.g., wheelchair, assistive devices)?*
If yes, please explain:
Adaptive Sports
What adaptive sports are you intersted in signing up for? (select all that apply)*

Basketball 2025: June 2nd, 9th, 16th, 23rdCheerleading 2025: June 2nd, 9th, 16th, 23rdFlag Football 2025: August 4th, 11th, 18th, 25thSoccer 2025: August 4th, 11th, 18th, 25thBaseball/Softball 2025: October 6th, 13th, 20th, 27th
Equipment
What size shirt for the athlete?
Top 2 number choices for the athlete:
Does the athlete need to borrow any equipment?*
If yes, please specify:
Would athlete benefit from softer equipment options? *
Volunteering
Would you or a family member (such as a sibling, aunt, or uncle) be interested in serving as your athlete’s buddy?*
If yes, please fill out volunteer registration form.
Would you be interested in being a friend?*
A friend in adaptive sports supports athletes with disabilities, ensuring safety, inclusion, and participation while encouraging skill-building and fun.
Photo and Media Consent:
Can we take photos or videos of athlete during activities to use for promotional purposes?*
Liability Waiver:
Please fill out liability form here: https://form.jotform.com/82464634960160
Registation Fee:

The registration fee helps ensure commitment to the program and secures your spot. If you need financial assistance, please contact us for more information.

Top'Hand in Hand

Adaptive Basketball June 2025

$20.00 Quantity

Adaptive Cheer June 2025

$20.00 Quantity

Adaptive Flag Football August 2025

$20.00

Adaptive Soccer August 2025

$20.00

Adaptive Baseball/Softball October 2025

$20.00

Enter coupon

Total

$0.00

Credit Card

Acknowledgment and Agreement:
By submitting this form, I understand that participation in adaptive sports involves inherent risks, and I accept responsibility for any associated risks. I agree to notify the program promptly if any contact information, medical details, or other relevant information changes. I confirm that all information provided is accurate to the best of my knowledge. For any questions or concerns, please contact us at tophandfoundation@gmail.com.
Parent signature*

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Top'Hand in Hand'

Participant Form

Health Information:

Adaptive Sports

Equipment

Volunteering

Photo and Media Consent:

Liability Waiver:

Registation Fee:

Credit Card

Acknowledgment and Agreement: