Desoto Chargers

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2017 Player/Cheerleader Registration

PLAYER INFORMATION

* First Name:

* Last Name:

* Street:

* City:

* State:

* Zip Code:

* Contact Phone Number:

* Birthdate:

* Gender:

* Grade:

PARENT/GUARDIAN #1

* Firstname:

* Lastname:

* EMail:

* Contact Phone Number:

* Cell Phone:

PARENT/GUARDIAN #2

Firstname:

Lastname:

Email:

Home Phone:

Work Phone:

Cell Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

* Emergency Contact:

* Phone:

* Relationship to Player:

Desoto Chargers Football Organization Liability Waiver

I the undersigned parent or legal guardian of the above child, give my permission for him or her to engage in this basketball program with the Desoto Chargers Football Organization. My child and I will at all times abide by the rules of the Desoto Chargers Football Organization and in the event of an infraction of the rules will accept the ruling of the Desoto Chargers Football Organization and that decision shall be final. All refunds requested by me from the Desoto Chargers Football Organization must be made in writing and prior to the first game. The only time that this is waived, would be if the Desoto Chargers Football Organization was to cease to exist or decide to not operate a particular team in which my child/children were registered to play on. This applies to ONLY those fees charged by the Desoto Chargers Football Organization. I understand that under NO circumstance is the Desoto Chargers Football Organization responsible for any portion of any other fee that is required by any other organization that the Desoto Chargers Football Organization agrees to participate with, should I request a refund. I/we intend to be legally bound, hereby for myself, my/our heirs, executors and administrators to waive and release any and all rights and claims for damages I/we have against all other entrants and against the Desoto Chargers Football Organization, its officers, agents and representatives for any and all injuries suffered by my/our child, while participating in the program, or while in transit to and from practice, practice games and league games. I give permission for the taking and usage of photos and video by Desoto Chargers Football.

MEDICAL RELEASE CONSENT FORM
As a legal parent or guardian of the above named player, I hereby give consent for emergency medical care prescribed by a licensed physician, hospital or medical clinic. This care may be given under whatever conditions are necessary to preserve the life; limb or well being of my dependent. I do hereby waive, release, absolve, indemnify, and agree to hold harmless the Desoto Chargers Football Organization and it's board members for any claim arising out of an injury to the player.

I/we agree with the above *

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2017 Player/Cheerleader Registration