2017 Rocky Mountain Soldierz Registration
Practice Dates: Every Tuesday & Thursday 6-8pm
Practice Location: Florida Pitt Waller School / 14250 E. Albrook Dr. Denver 80239
Contact us: Coach Joel 720-240-7200
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Participants Date of Birth *
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Participants Age *
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Participant Height *
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Participant Weight *
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Participant uniform size *
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School Attending & Grade *
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Parent Name *
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Medical restrictions *
RELEASE OF LIABILITY:PARENTAL CONSENT The law requires that parental permission be obtained for operative procedures on minors. The parent should sign the following consent form so that such procedures may be carried out in the event of an emergency without delays to operative procedures. No operation will be performed, except in emergency, without parents being contacted and fully informed. I Parental/Guardian of Give permission for such diagnostic, therapeutic, and operative procedures as may be deemed necessary for my son/daughter. I hereby state that Struggle of Love Foundation is not responsible for any pre-existing injury or recurrence of undisclosed injury or illness or the administration of any medications of the above individual. I agree to accept all costs related to treatment. I give my authorization for my child to participate with Struggle of Love Foundation, and hereby release, indemnify, and hold harmless Struggle of Love Foundation and its staff, and agents from any claim or liability for accident or injury that occurs while participating. This is an activity that injuries may occur and could be serious in nature. I, the parent or legal guardians of the above registrant acknowledges and understands that I am solely responsible for any medical expenses that may occur. Photography Release This letter also confirms the agreement between you and Struggle of Love Foundation regarding participation in any activities in which your child may be photographed or videotaped from time to time. You hereby agree that it becomes the property of SOL Foundation and you hereby release , its directors, officers, successors and assigns from and against any and all claims, demands, actions, causes of actions, suits, costs, expenses, liabilities, and damages whatsoever that you may hereafter have against SOL Foundation in connection with the Property. This agreement shall not obligate Struggle of Love Foundation. Parent/Guardian Signature ____________________ _ Date __________________ *
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