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2018 Seaside Kids Youth Football Registration
Online Seaside Kids Football Registration to play football in the fall of 2018.
Player Last Name *
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Player First Name *
Your answer
Player Grade in the Fall of 2018 *
Parent Name *
Your answer
Parent Phone Number *
Your answer
Parent Email *
Your answer
Parent Mailing Address *
Your answer
I have insurance with _______________ (name of company): (SKI will cover insurance cost if you are uninsured, please be certain to sign waiver) *
Your answer
Insurance Policy or ID # *
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Insurance Group # *
Your answer
Consent For Medical Care & Treatment *
Please notify the undersigned parent or guardian as noted below in case of an accident, serious illness or other emergency. In the event you are unable to notify me, I hereby authorize medical personnel to secure whatever medical or surgical care is deemed reasonably necessary. Also, the undersigned further agrees to guarantee payment therefore.
Name of Family Physician *
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Physician Phone Number *
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Allergies or Special Medical Conditions *
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Emergency Contact in Case You Cannot Be Reached *
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Emergency Contact Phone Number *
Your answer
Waiver and Release of Liability: In consideration of being allowed to participate in the Seaside Kids, Inc. football program, the undersigned acknowledges and fully understands that each participant will be engaging in activities that involve risk of serious injury, including permanent disability and death. Further, there may be other risks not known to use or not reasonably foreseeable at this time. The undersigned agrees to assume all of the financial obligations following such injury, disability, or death. The undersigned releases and agrees not to sue Seaside Kids, Inc., their coaches, and directors from all liability. *
I/We have read the above waiver and release and agree to the terms outlined. I/We give up substantial rights by signing the release and have signed it voluntarily. I understand that printing my name below is the same as signing my name on a paper form.
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