PARENT CONSENT, WAIVER AND RELEASE
D1 Football
P.O. Box 20
Chardon, Ohio 44024
Date of Event: _________________
Location of Event : ____________________________________________
In consideration of the ULTIMATE FOOTBALL COMBINE acceptance of
(Please print your child’s full name)___________________________________
As a athlete for the event mentioned above, and in return for the opportunity toparticipate in this
combine: It is agreed that all risks attendant to watching and/or participating in combine activities,
including, but not limited to bodily injury, are assumed by the athlete and his parents and/or legal
guardian and that this assumption is acknowledged, approved, and agreed to by said athlete and his
parents and/or legal guardian as indicated by the signature hereto. D1 Football will be financially
responsible for and has insurance that will cover most injuries/accidents occurring during combine,
but only as secondary coverage after parents/guardians insurance has paid. I hereby certify that the
above named athlete is physically able to participate in The ULTIMATE FOOTBALL COMBINE event and
that I know of no physical impairments which would in any manner limit his/her participation in such a
program. I hereby grant permission for physicians, dentists, other licensed health care providers and
their designees employed by D1 Football to administer outpatient medical, surgical, or dental services
as appropriate, or necessary antigens or other injections, to perform emergency procedures as
necessary or to refer to duly licensed medical personnel when indicated. In consideration for honoring
my child's request to participate in the above activity, I, for myself, my executors, administrators, and
assigns, do hereby release and forever discharge D1 Football, and The ULTIMATE FOOTBALL COMBINE
its respective entities, administrators, employees, agents, from any claims that I might have myself or
could bring on my child's behalf with regard to damages, demands, or any actions whatsoever,
including those based on negligence or failure to supervise, in any manner arising out of my child's
participation in this activity. I recognize that this Release means that I am giving up, among other
things, rights to sue D1 Football, its respective entities, administrators, employees, and/or agents, for
injuries, or damages or losses that my child may incur. I authorize (UFC) to use any photographs, results or articles about my child for publicity purposes or otherwise.
_____________________________________
Please Print Parent or Legal Guardian Name
_____________________________________
Parent or Legal Guardian Signature
_____________________________________
Date
|