Participation in tackle football requires the ability to understand the rules of the game and to
physically participate in the game.
Does your child have any current condition that limits his/her ability to participate in this activity?
YESNO
If “YES please explain here
AUTHORIZATION
I/We, the parents and/or guardian of the above named candidate for a position on a Cumberland/North Yarmouth Football team hereby give my/our approval to participate in any/all team and league activities. I/We assume all risks and hazards incidental to such participation, including transportation to and from activities; and I/We do hereby waive, release, absolve, indemnify and agree to hold harmless Cumberland/North Yarmouth Football Boosters Club, the league, members, officers, sponsors, participants, and persons transporting my/our child to and from activities; for any claim arising out of an injury to my/our child, whether the result of negligence or from any other cause, except to the extent and in the amount covered by accident and liability insurance. I/We understand that the insurance carried by this club covers only the amount not paid by my/our carrier. In the event of illness or injury, I/We give my/our permission to seek any emergency medical treatment necessary. I/We agree to return upon request the uniform and other equipment issued to my/our child in as good as condition as when issued except for normal wear and tear.
Each participant must have medical insurance.
Please list Insurance Co and policy number.
