Alabama Fire Football Tryout Registration Form

Athlete Information

Athlete's Name

First NameLast Name

Birth Date

MonthDayYear

Previous Sports Played

YesNo

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Name

First NameLast Name

Home Number

Cell Number

E-mail

example@example.com

Emergency Information

Emergency Contact's Name

First NameLast Name

Relationship

Phone Number

Alt. Phone Number

Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.

Is the athlete prescribed an inhaler? If yes, please explain any instructions.

Informed Consent and Acknowledgement I hereby agree to participate in any and all activities prepared by the Alabama Fire Tackle Football during these tryouts. I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Alabama Fire Tackle Football and all its respective officers, agents, and representatives from any and all liability for injuries that may arising out of traveling to, participating in, or returning from this voluntary tryout. In case of injury, I hereby waive all claims against Alabama Fire Tackle Football, including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including football. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

Medical Release and Authorization I hereby authorize my diagnosis and treatment by a qualified and licensed medical professional, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the my life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed. Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact my next of kin in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me. Permission is also granted to the Alabama Fire Tackle Football and its affiliates including its Coaches to provide the needed emergency treatment prior to my admission to the medical facility. Release authorized on the dates and/or duration of the registered season. This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances.

Confirmation BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

2021 Football Tryout Registration