Team Registration: 4-8 players per team
$425 per team from 4/17/14-5/9/14
$475 per team from 5/10/14-5/31/14
$525 per team from 6/1/14-6/13/14
$15 per each additional player over 8
Each season has 10 games, a Prime Time t-shirt,
and a season ending tournament
Team Name:
How Many Players:
Amount Paid:
Billing Information:
Payment Information:
*First Name:
Credit Card:
*Last Name:
Credit Card Number:
*Address:
Exp Date:
*City:
Security Code:
State:
Billing zip code:
*Zip Code:
*Phone Number:
*Email Address:
RELEASE OF LIABILITY FOR PARTICIPANTS
READ BEFORE SIGNING
IN CONSIDERATION OF _________________________________________ being allowed to participate
in any way in PRIME TIME ATHLETICS, LLC. related events and activities, the undersigned
acknowledges, appreciates, and agrees that:
1.
The risk of injury to myself from the activities involved in these programs is significant,
including the potential for permanent disability and death, and while particular rules, equipment,
and personal discipline may reduce this risk, the risk of serious injury does exist; and,
2.
I FOR MYSELF KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known
and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES or others,
and assume full responsibility for my child’s participation; and,
3.
I willingly agree to comply with the program’s stated and customary terms and conditions for participation. If I observe any unusual significant concern in my child’s readiness for participation and/or in the program itself, I will remove my child from the participation and bring such attention
of the nearest official immediately: and,
4.
I for myself and on behalf of my/our heirs, assigns, personal representatives and next of kin,
HEREBY RELEASE AND HOLD HARMLESS PRIME TIME ATHLETICS, LLC. it’s directors, officers, officials, agents, employees, volunteers, other participants, sponsoring agencies, sponsors,
advertisers, and if applicable, owners and lessons 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 incident to my involvement or participation in these programs,
WETHER ARISING FROM THE NEGLIGENCE OF THE RELEASES OR OTHERWISE, to the
fullest extent permitted by law.
5.
I, for myself and on behalf of my/our heirs, assigns, personal representatives and next of kin,
HEREBY INDEMNIFY AND HOLD HARMLESS all the above Releasees from any and all
liabilities incident to my child’s involvement or participation in these programs, EVEN IF ARISING FROM THEIR NEGLIGENCE, 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 BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY
WITHOUT ANY INDUCEMENT.
____________________________________________
_________________________________________
(PLAYER SIGNATURE)
DATE SIGNED: ______________________________
(PRINT NAME)
RELEASE OF LIABILITY FOR MINOR PARTICIPANTS
READ BEFORE SIGNING
!IN CONSIDERATION OF _________________________________________, my child or ward, being
allowed to participate in any in way in PRIME TIME ATHLETICS-related events and
activities, including but not limited to flag football leagues, football camps, cheerleading and football
practices (the “Events”), the undersigned acknowledges, appreciates, and agrees that:
!1. The risk of injury to my child or ward from participation in the Events is significant,
including the potential for permanent disability and death, and while particular rules,
equipment, and personal discipline may reduce this risk, the risk of serious injury does exist;
and,
!2. I for myself, my spouse, and my child or ward, and on behalf of our heirs, assigns, personal
Representatives, executors, administrators and next of kin, KNOWINGLY AND FREELY ASSUME ALL
SUCH
RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE
RELEASEES (as defined below) or others, and assume full responsibility for my child or ward’s
participation in the Events; and,
!3. I willingly agree to comply with the Events’ stated and customary terms and conditions for
participation. If I have any unusual or significant concern regarding my child or ward’s readiness for
participation or regarding the Events themselves, I will remove my child or ward from participation in the
Events and bring such concern to the attention of the nearest Prime Time Athletics official immediately;
and,
!4. I for myself, my spouse, my child or ward, and on behalf of my/our heirs, assigns, personal
Representatives, executors, administrators and next of kin, HEREBY RELEASE AND HOLD
HARMLESS Prime Time Athletics Franchise Systems, LLC, and all of its franchisees and affiliates,
including but not limited to the franchise operating in my local area, in addition to all of the
aforementioned entities’ owners, directors, officers, officials, agents, employees, assigns and volunteers,
as well as other participants in the Events, sponsoring agencies, sponsors, advertisers, and lessors of
premises used to conduct the Events (collectively, “Releasees”), WITH RESPECT TO ANY AND
ALL PHYSICAL OR EMOTIONAL INJURY, DISABILITY, DEATH, or loss or damage to person or
property directly or indirectly arising from or related to my child or ward’s involvement or participation in
the Events, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR
OTHERWISE, to the fullest extent permitted by law. However, this agreement does not apply to acts of
gross negligence, willful or wanton conduct, or intentional conduct by the Releasees; and
!5. I for myself, my spouse, my child or ward, and on behalf of my/our heirs, assigns, personal
Representatives, executors, administrators and next of kin, HEREBY AGREE NOT TO SUE, MAKE OR
FILE ANY LAWSUITS, CLAIMS, PROCEEDINGS OR ANY OTHER ACTIONS OF ANY KIND
WHATSOEVER against any of the Releasees for bodily injury, property damage, disability or death
sustained during my child or ward’s participation in the Events to the fullest extent permitted under the
law, including allegations or claims of negligence on the part of any of the Releasees; however, this
agreement does not apply to acts of gross negligence, willful or wanton conduct, or intentional conduct by
the Releasees.
!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.
!Signature_______________________________________________
Age__________ Date__________