2022 Carolina Scorpion Flag Registration
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Email *
Player Full Name *
Player Date Of Birth *
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Age *
Player Contact Number *
Address *
Player Position *
Years Of Experience   *
Medical Condition(s) Allergies *
Medications *
Emergency Contact Name *
Emergency Contact Phone *
Available Days For Practice *
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Time Available Day or Night *
Time
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Carolina Scorpion Liability Waiver I have read and agree to the Waiver requirements In consideration of being allowed to participate in the event or activity hosted by WFFLC, I acknowledge, appreciate, and agree that: 1) The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and serious injury does exist; and, 2) I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full resp 3) I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or par bring such to the attention of the nearest official immediately; and, 4) I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS the Releasees, their officers, officials, agents agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event ("RELEASEES"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS WITHOUT ANY INDUCEMENT. Covid/Communicable Diseases Waiver * IN CONSIDERATION of being permitted to compete, officiate, observe, work, or participate in any way in the EVENTS(S), I for myself, my personal representative been diagnosed with, demonstrated any symptoms of or have in any way been exposed to any communicable diseases (including but not limited to the virus common thirty days; 2) Acknowledge that I am aware that by entering the premises and participating in the EVENTS(S) that there are risks to me and to those with whom I in communicable disease(s) including but not limited to the virus "severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)", "COVID-19" and/or any mutation to RELEASE, WAIVE, DISCHARGE and COVENANT NOT TO SUE on behalf of myself or on behalf of others with whom I interact, the participants, officials, conduct EVENT(S) and each of them, their directors, officers, agents and employees, all for the purposes herein referred to as "Releasees", from all liability to the u heirs, and next of kin for any and all loss or damage, and any claim or demands therefore, whether caused by negligence of the Releasees or otherwise; 4) HEREBY a HARMLESS the Releasees and each of them from any loss, liability, damage, or cost they may incur arising out of or related to my illness or death, whether caused I HAVE READ THIS COMMUNICABLE DISEASE RELATED HOLD HARMLESS, RELEASE, WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT MADE TO ME AND INTEND MY SUBMISSION TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT. *
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Signature *
Date *
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SIGNAGE OF THIS INTEREST FORM DOES NOT OBLIGATE YOU TO JOIN THE CAROLINA SCORPION FOOTBALL TEAM. ANY INFORMATION OR MEDIA YOU ARE PRIVILEGED TO WHILE PERFORMING WITH THE CAROLINA SCORPION FOOTBALL TEAM IS PRIVATE PROPRIETARY INFORMATION WHICH IS EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW.  
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