Registration form

AIEA JR. ALI'I

TACKLE FOOTBALL
REGISTRATION / WAIVER FORM

SEASON: FALL 2023
PLAYERS LEGAL NAME

First NameLast Name
NICKNAME
Address

ADDRESS

Street Address Line 2

CITYState / Province

ZIP CODE
BIRTHDAY

MonthDayYear
Date
AGE
GRADE
SCHOOL
FATHERS NAME

First NameLast Name
PHONE NUMBER
Format: (000) 000-0000.
MOTHERS NAME

First NameLast Name
PHONE NUMBER
Format: (000) 000-0000.
Please indicate who the primary contact will be
E MAIL ADDRESS for AJA UPDATES & INFO
example@example.com
EMERGENCY CONTACT'S NAME
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
DOCTOR'S NAME
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
WAIVER: All information submitted is true. Also, in return for being allowed to participate in the AIEA JR. ALI'I Football program, I release and agree not to sue AIEA JR. ALIT Football, AYF or Jr. Prep Sports Hawaii, its' familiies, estate, heirs or assigns for property damage, personal injury or wrongful death arising as a result of the participant's participation in the league and caused by ordinary negligence of the parties listed above, wherever or however the same may occur. I understand that AJAF, AYF, JPS and it's entities are not responsible for any injury or property damage arising out of the league, even if caused by their ordinary negligence. understand that participating in the league involves certainrisks including and agree to accept all risks of such participation. I certify that my child is in excellent physical health and can participate in the strenuous and hazardous physical activities, including the football exercises to be participated in the league.I grant to allow my child to receive emergency medical treatment, if needed. also agree to indemnify and hold harmless AJAF, AYF, JPS and its entities from all claims arising out of my child's participation in the above parties use my child's name, photo and demographic information free of charge in any manner and for any purpose in any media now known or hereafter created I understand that this document is intended to be as broad and inclusive as permitted by the laws of the state of Hawaii in which the league is taking place and agree that if any portion of this agreement is invalid, the reminder will continue in full legal force and effect. Turther agree that any legal proceedings related to this waiver will take place in the state of Hawaii.

PARENT/GUARDIAN VOLUNTEER REQUIREMENT (SCHEDULED SNACKS, FUNDRAISERS, ETC: I understand that by participating in the AJA program that will be expected to support all fundraising activities. I will be expected to volunteer/support through snacks and/or donations. - fully understand my role.

NO REFUND POLICY: I UNDERSTAND AND COMPLY WITH THE 'NO REFUND' POLICY SET FORTH BY THE AIEA JR. ALI'I FOOTBALL ORGANIZATION.
PARENT/GUARDIAN'S
Signature
DATE

MonthDayYear
Date

AIEA JR. ALI'I

REGISTRATION / WAIVER FORM

PARENT/GUARDIAN'S