Name * First Name Last Name Email * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone (###) ### #### Age * Player Position * T-shirt Size * XS S M L XL 2XL 3XL Health Concerns/Food Allergies * How did you hear about us? * Parent/Legal Guardian Info Name * First Name Last Name Email * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Release of Liability I understand by the very nature of the activity, football carries a risk of potential injury. No matter how careful the player and coach are, I understand that there is a risk of injury. The risk includes minor injuries such as broken bones, dislocations and muscle pulls. The risk also includes catastrophic injuries such as permanent paralysis or even death from landing or falling on the back, head or neck. The undersigned agrees, individually and on behalf of the child, that the child, by and through the undersigned or any other person, will not institute or commence any action at law or equity for any damage of any kind that may be sustained by the child as a result of participation in the program. The undersigned further agrees, individually and on behalf of the child, to release, indemnify and hold harmless the organization, its successors, members, directors, officers, coaches, sponsors and volunteers from any claims, demands or actions at law or equity that may subsequently be brought by or on behalf of the child to recover for injuries or damages, including claims for contribution or indemnification made by third parties, arising out of injuries resulting from participation in the program. Do you agree with the Liability Statement Above? * Yes No Date * Today's Date MM DD YYYY Thank you! REGISTER FOR THE NICO COLLINS FOOTBALL CAMP
