REGISTRATION

Accepting Fall Registrations

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Name *

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Parent/Guardian Name *

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Parent phone number/email *

Date of Birth *

List Health Conditions *

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**I HEREBY AUTHORIZE MY CHILD TO PARTICIPATE IN THE CHAMPIONS FOOTBALL PROGRAM AND I ASSUME ALL RISK AND HAZARDS INCIDENT TO SUCH PARTICIPATION, INCLUDING TRANSPORTATION TO AND FROM SAID ACTIVITIES, WAIVE, RELEASE, ABSOLVE, INDEMNIFY AND AGREE TO HOLD HARMLESS CHAMPIONS FOOTBALL ACADEMY, ITS AFFILIATES, THE ORGANIZERS, SUPERVISORS, OFFICERS, DIRECTORS, PARTICIPANTS AND PERSONS OR PARENTS SUPERVISING OR TRANSPORTING PARTICIPANTS FROM SUCH ACTIVITIES FROM ANY CLAIMS ARISING OUT OF INJURY TO MY CHILD.**

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