I ACKNOWLEDGE BY SUBMITTING THIS FORM THAT I HAVE FULLY READ THE PARENTAL AUTHORIZATION & INDEMNIFICATION (listed below) AND AGREE AND CONSENT TO THESE TERMS AND CONDITIONS AND THE INFORMATION I HAVE DOCUMENTED IS TRUE and ACCURATE INFORMATION.
PARENTAL AUTHORIZATION & INDEMNIFICATION
The undersigned parent and/or guardian of the above-named minor, hereby consents to the full participation by the above-named minor in Youth Football and agree for said minor to be assigned to a community and team.
I acknowledge that the activities that my child will be involved in may be dangerous in nature and I represent that I know and understand those dangers to which my child will be exposed. I specifically acknowledge and understand that football/cheerleading is a sport with risk of serious injury or even death.
I do hereby voluntarily assume on behalf of the above-named minor each, every, and all risks and/or hazards to which said minor or myself might be exposed during activities including, but not limited to, playing said sport, cheerleading and/or transportation to and from all activities and medical attention of any nature resulting from injuries sustained in these activities, or sustained in acts of God, acts of terrorism, strikes, civil disorder, and/or any epidemics/pandemics.
I do hereby WAIVE, RELEASE, ABSOLVE AND AGREE TO INDEMNIFY PAY AND HOLD SAFE AND HARMLESS said football/cheerleading program, its entire organization, the local league/community, their coaches, participants, Board of Directors, all officers, all assistants, persons and/or organizations that transport the participants for any purpose as well as the city, city administrators and/or government officials which each organization resides/participates in from all claims, injuries, damages of both a compensatory and punitive nature and for any and all other claims and/or damages which might arise out of and/or due to the above-named minor's participation in said activities.
The parent/guardian whose signature appears below does hereby consent to any and all medical treatments including anesthesia and operations which may be deemed necessary by medical care providers attending to the above-named minor for injuries sustained in the activities. I further agree and acknowledge that I am responsible for all charges incurred in connection with treatment and care rendered to the above-named minor pursuant to this agreement.