Black Widows Girls Flag Football

ATHLETE NAME*

First NameLast Name

Date of Birth*

MonthDayYear

Age

Please note that any player that registered in the incorrect age level, for a competitive advantage will be disqualified to participate in BWFFL program.: *Athlete can play up but not down.

Grade

Friend Request # 1 (First and Last Name):

We strive to honor all friend requests. As we review our registrations, we review coaching requests first then we review friend requests. We work to honor as many requests as possible based on our total registration.

Friend Request # 2 (First and Last Name):

We strive to honor all friend requests. As we review our registrations, we review coaching requests first then we review friend requests. We work to honor as many requests as possible based on our total registration.

List any siblings in the program (First and Last Name):

Parent Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Interested In Volunteering:

Head CoachTeam ManagerAssistant CoachNot interested involunteering

Relationship to Player

Parent / Guardian #2

First NameLast Name

Interested inVolunteering:

Head CoachTeam ManagerAssistant CoachNot interested involunteering

EMERGENCY CONTACT *

First NameLast Name

Phone Number*

Please enter a valid phone number.

Email*

example@example.com

WAIVER & RELEASE FORM PARTICIPANT RELEASE OF LIABILITY

In consideration of being allowed to participate in the Black Widows FFL, Inc. program, I, the undersigned participant (or parent/guardian if the participant is under 18), agree to the following:

Acknowledgment of Risk
I understand that participation in flag football involves certain inherent risks, including but not limited to physical contact, injuries, accidents, and even the possibility of death. I voluntarily assume all risks associated with participating in this activity, including but not limited to falls, collisions, equipment failure, weather conditions, and actions of other players.

Health and Physical Fitness
I certify that I am (or my child is) in good health and physically capable of participating in flag football activities. I understand that it is my responsibility to consult with a physician before participating if I have any concerns about my health or fitness level.

Medical Treatment Authorization
In the event of an emergency and I am unable to be reached, I hereby give permission Black Widows FFL Inc. to seek medical treatment for myself (or my child) as necessary for medical treatment and related transportation to any licensed physician, surgeon, clinic, hospital, or ambulance service to secure proper treatment, for my child as named above. I understand that I am responsible for any medical expenses incurred as a result of injury or illness during participation.

Release of Liability
I hereby release, discharge, and hold harmless Black Widows Girls Flag Football, its coaches, staff, volunteers, sponsors, and associated facilities from any and all liability, claims, demands, actions, or causes of action arising out of any injury, illness, damage, or loss that may result from participation in this program. This includes claims arising from the negligence of the aforementioned parties.

Indemnification
I agree to indemnify and hold harmless Black Widows Girls Flag Football, its affiliates, employees, and volunteers from any liability, loss, or damage, including reasonable attorneys' fees, arising from or in connection with my (or my child’s) participation in this program.

Compliance with Rules and Instructions
I agree to follow all safety guidelines, rules, and instructions provided by the coaches, staff, and officials of Black Widows FFL Inc., failure to comply with these rules may result in removal from the program without refund.

Photo/Video Release

I hereby grant Black Widows FFL Inc. the irrevocable right and permission to use photographs and/or video recordings of me on websites and in publications, promotional flyers, educational materials, derivative works, or for any other similar purpose without compensation to me. I understand and agree that such photographs and/or video recordings of me may be placed on the Internet. I also understand and agree that I may be identified by name and/or title in printed, Internet or broadcast information that might accompany the photographs and/or video recordings of me. I waive the right to approve the final product. I agree that all such portraits, pictures, photographs, video and audio recordings, and any reproductions thereof, and all plates, negatives, recording tape and digital files are and shall remain the property of Black Widows FFL Inc. I hereby release, acquit and forever discharge Black Widows FFL, Inc., its current and former trustees, agents, officers and employees of the above-named entities from any and all claims, demands, rights, promises, damages and liabilities arising out of or in connection with the use or distribution of said photographs and/or video recordings, including but not limited to any claims for invasion of privacy, appropriation of likeness or defamation. I hereby warrant that I am eighteen (18) years old or more and competent to contract in my own name or, if I am less than eighteen years old, that my parent or guardian has signed this release form below. This release is binding on me and my heirs, assigns and personal representatives.

Athlete Name*

First NameLast Name

Parent Name*

First NameLast Name

I AGREE TO THE ABOVE TERMS & CONDITIONS!*

YesNo

Signature

My Products*

Developmental ProgramMonthly

$105.00 Quantity

Enter coupon

Total

$0.00

Payment Methods

Debit or Credit Card

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Contact Info

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