West Mesquite Stampede

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Stampede Football Online Registration Form - Athlete

PLAYER INFORMATION

* First Name:

* Last Name:

Street:

City:

State:

Zip Code:

Home Phone:

* Birthdate:

Email:

Gender:

Grade:

PARENT/GUARDIAN #1

Firstname:

Lastname:

EMail:

Home Phone:

Work Phone:

Cell Phone:

PARENT/GUARDIAN #2

Firstname:

Lastname:

Email:

Home Phone:

Work Phone:

Cell Phone:

WAIVER INFORMATION

AMATEUR ATHLETIC MINOR WAIVER AND RELEASE OF LIABILITY

In consideration of being allowed to participate in any way in Metroplex Youth Football League Athletic/sports program. and related events and activities, the undersigned:

1. Agrees that the parent(s) and/or legal guardian(s) will instruct the minor participant that prior to participating he or she should inspect the facilities and equipment to be used and if the participant believes anything is unsafe, he or she should immediately advise his or her coach or supervisor of such condition and refuse to participate.

2. ACKNOWLEDGES AND FULL Y UNDERSTANDS that each participant will be engaging in ACTIVITIES THAT INVOLVE RISK OF SERIOUS INJURY, INCLUDING PERMANENT DISABILITY AND DEATH, and severe social and economic losses which might result not only from their own actions, inactions or negligence, but the actions, inactions or negligence of others, the rules of play, or the condition of premises or of any equipment used. Further, that there may be other risks not known to us or not reasonably foreseeable at this time.

3. ASSUMES ALL THE FOREGOING RISK AND ACCEPT PERSONAL RESPONSIBILITY FOR THE
DAMAGES following such injury, permanent disability or death.

4. RELEASES, WAlVES, DISCHARGES AND COVENANTS NOT TO SUE THE
Metroplex Youth Football League, its affiliated clubs, their respective administrators, directors, agents, coaches, representatives, sponsors, and other employees of the organization. Other participants, sponsoring agencies, advertisers, and if applicable, owners and leasers of premises used to conduct the events, all of which are hereinafter referred to as "releases", from any and all liability of each of the undersigned his or her heirs and next of kin for any and ALL CLAIMS, DEMANDS, LOSSES OR DAMAGES ON ACCOUNT OF INJURY, INCLUDING DEATH OR DAMAGE TO PROPERTY, CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

I (WE) HAVE READ THE ABOVE WAIVER AND RELEASE, UNDERSTAND THAT WE HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND SIGN IT VOLUNTARILY.

I/we agree with the above *

Signature:

Date:

Signature:

Date:

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Stampede Football Online Registration Form - Athlete