As the parent or legal guardian of the child named below, I hereby give my full consent and approval for my child to participate as a member in the Rockaway Rockets Football Association, Inc. I understand that there are certain risks of injury inherent in the practice and play of football and cheerleading, as well as traveling and other related activities incidental to my child’s participation. I am willing to assume these risks on behalf of my child.

I hereby certify that my child is fully capable of participating in the sport and that my child is healthy and has no physical or mental disabilities or infirmities that would restrict full participation in these activities, except as listed below. I approve emergency treatment for my child by certified emergency personnel (i.e., EMT, First
Responder, E.R. Physician).

I also hereby waive, release and hold harmless the Rockaway Rockets Football Association, Inc., its officers, coaches, sponsors and any representatives for any participation in the designated sport and the activities incidental thereto, regardless of cause. I also agree and fully understand that the Rockaway Rockets Football
Association Inc., as a volunteer, not for profit organization is not liable for any medical expenses incurred due to any injuries that may be sustained.

I attest that I have gone to the Rockaway Rockets Football Association, Inc. website (www.rtrockets.com) and have read the Rockaway Township Code of Conduct, Cheer Rules and Regulations, Rockets Parent Child Handbook (including all addendums) and Booster Volunteer forms. My signature below verifies that my family has read all forms and fully agrees to comply with the responsibilities and requirements listed in each form.