Ver 5/06

Athlete’s First_________________ Initial ___ Last Name ____________________ Birthdate:_____________

Address _________________________________ City ___________________ State _____ Zip _________

Phone ___________________ Email _______________________________________

Parent/Guardian (Please Print) – First ___________________ Last Name______________________

Safety/Permission Release

I/We the parents/legal guardians of the named participant, hereby give my/our approval for the above child to participate in any and all New Castle County Football League (hereafter referred to as NCCFL) activities. I /We assume all risks and hazards incidental to such participation, including transportation to and from activities. I/We the undersigned :

1. Agree that the parent(s) and/or legal guardian(s) will instruct the minor participant that prior to participating he or she should inspect the facilities and equipment to be used, and if the participant believes anything is unsafe, he or she should immediately advise his or her coach or supervisor of such condition(s) and refuse to participate.

2. Acknowledge and fully understand that each participant will be engaging in activities that involve risk of serious injury, including permanent disability and death, and severe social and economic losses which might result not only from their own actions, inactions, or negligence, but the action, inaction, and negligence of others, or the condition of the premises, or of any equipment used. Further, that there may be other risks not known to us or not reasonably foreseeable at this time.

3. Assume all the foregoing risks and accepts personal responsibility for the damages following such injury, permanent total disability, or death.

4. Release, waive, discharge and covenant not to sue Capitol Trail Junior Football League dba/New Castle County Football League, its affiliated clubs, their respective administrators, directors, agents, and other employees of the organization, other members/participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event, all of which are hereinafter referred to as "releases," from any and all liability to each of the undersigned, his or her heirs and next of kin for any and all claims, demands, losses or damages on account of injury, including death and damage to property, caused or alleged to be caused in whole or in part by the negligence of the releases or otherwise. I agree to absorb all cost, liabilities, and monetary damages that might arise from any suit filed by the above participant, or on his/her behalf by any other party against the above releases.

I/We acknowledge that my/our child is in sufficiently good physical condition and health to participate in the program. I/We hereby release the NCCFL, it’s Officers, Directors, Coaches and others affiliated with the program from any and all liabilities arising from the participant engaging in the program. I agree to absorb all costs and liabilities from any suit brought by the above listed participant. It is understood that while NCCFL strongly recommends a physical exam before the season, it is the parent/guardian’s responsibility to provide such physical exam. I/We assume full responsibility for ascertaining our minor participant’s health to participate. I/We understand that no athlete may participate or perform in games or practice with a cast! A doctors note of approval must be supplied after removal to renew participation.

Because of the very serious safety concerns involved with football, it is understood that only NCCFL issued helmets and shoulder pads are to be worn during practices and games. No one, including NCCFL Coaches or Directors, has the authority to outfit participants with shoulder pads or helmets, except at official times designated at the NCCFL storage warehouse.

Parent/Participant Obligations

I/We must attend the annual Parent Awareness/Safety Training for our athlete to obtain his/her uniform and equipment. Equipment will not be issued to participant under any circumstances until this obligation has been fulfilled. I/We understand that class sizes are limited and it is our responsibility to sign-up for an available class.

I/We will furnish NCCFL with the original (for viewing only) and a copy of participant’s birth certificate, this signed permission form, payment of the non-refundable sign-up fee of $40, and payment of participation fees and fundraising minimum at equipment handout. It is understood that participant must sell minimum required raffle tickets or buy out for $100.00 and participate in any additional fund raisers or buy out for $60. All payments to NCCFL must be cash, MC, Visa, certified check or money order. This includes all fundraising.

I/We understand that my/our conduct, the conduct of the participant and that of all family members and guests may affect the status of participant. NCCFL will not tolerate abusive language, alcohol, or misconduct at any of its functions.

I/We understand that membership in the NCCFL is at the discretion of the NCCFL Executive Board and may be revoked for failure in obeying rules or endangerment of the safety, welfare or reputation of the League, it’s officers or participants. I/We understand that this will result in forfeiture of all payments made to NCCFL.

I/We understand that any suit brought by against the NCCFL or its officers will result in our immediate removal from the League, including any awards, trophies, etc. which might otherwise be presented.

Awards, yearbooks, trophies, and ceremonies are not guaranteed by this contract. They are presented at the discretion of NCCFL and are available only during their presentation times to those athletes successfully completing the season and equipment return obligations.

I will perform my volunteer duties (Trash, Field day, Chains, etc.) ____ or Gold/Platinum Benefactor Buyout _____

I have read the above waiver and release, understand that I have given up substantial rights by signing below, and sign it voluntarily.

Parent/ Legal Guardian Signature____________________________________________________ Date _________________

Address ___________________________________________ City _____________________ State ________ Zip ______________

Relationship _______________________________ Phone ____________________ Drivers Lic/ID # ________________________