2020-2021 (Spring/Fall) Middletown Eagles' Player Interest Form
We are anxious to get the ball rolling for all of our teams this Fall and may need to add players! We anticipate needing players outside the organization to fill out our rosters. Please complete the Player Interest Form and you will be contacted!
Coach Ryan Spillane
LAST NAME, FIRST NAME
If you have any conflicts with one or both seasons please list/explain in as much detail as possible. (i.e.-Football/Soccer etc.)
DATE OF BIRTH
JERSEY SIZE (We are gathering this info to have on record in the event that your joins the Middletown Eagles.
JERSEY # OPTION #1
JERSEY # OPTION #2
JERSEY # OPTION #3
Hold Harmless Agreement/Player Waiver: In consideration of being allowed to participate in the event or activity referenced above, I acknowledge, appreciate, and agree that: 1) The risk of injury/illness from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury/illness does exist; and, 2) The risk to have contact with individuals, who have been exposed to and/or have been diagnosed with one or more communicable diseases, including but not limited to COVID-19 or other medical conditions, diseases, or maladies does exist, and it is impossible to eliminate the risk that I could be exposed to and/or become infected through contact with or close proximity with an individual with a communicable disease. 3) 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 responsibility for my participation; and, 4) I willingly agree to comply with the stated and customary terms and conditions for participation including those requirements set forth in the NJDOH guidelines which are appended to this waiver and incorporated herein by reference. Consistent with these guidelines I acknowledge that Releasor's temperature will be taken prior to each session. The Releasor acknowledges that if the participant's body temperature is above that recommended by the NJDOH guideline, the participant may not take part in the session. Moreover, if the participant demonstrates any sign of illness prior to a practice or game, the participant may not take part. If within 14 days prior to the start of the season or anytime during the season, the participant has been exposed to anyone who has tested positive for or suspected to have contracted COVID-19, the participant may not take part in practice or games until a negative test result is documented and the player quarantines for 14 days. If, however, I, observe any unusual significant hazard during my son's presence or participation, I will remove him from participation and bring such to the attention of the nearest official immediately; and, 5) 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, and/or employees, other participants, sponsoring 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, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.6) I have read and understand the NJDOH guidelines and agree to comply with all State and Local guidelines.I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
Yes, I have read and agree to the Hold Harmless Agreement/Player Waiver.
No, I do not agree.
Send me a copy of my responses.
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