TIGER LEAGUE FOOTBALL
CONSENT, WAIVER AND RELEASE AGREEMENT
The parent or guardian of the below named participant for and in consideration of being allowed to participate in the programs and
activities of Tiger League Football, including, but not limited to, excursions sponsored by the Tiger League Football Program or any of its related
activities whether above listed or not, does hereby agree that in any suits and/or actions which may hereafter be instituted by the undersigned for
damages resulting from illness or injuries of whatsoever nature sustained by the participant or the undersigned while participating in the activities of
the Tiger League Football program or any related undertaking, this Agreement shall be urged by the Tiger League Football Program as a bar to any
such recovery by the undersigned on account of any injury or illness so sustained.
For the same consideration above recited, the undersigned does hereby release and discharge the Tiger League Football Program, its
representatives, agents and/or servants of account of any injuries or illness sustained to or by the participant or the undersigned, by whatever cause or
reason; and the undersigned does hereby agree to hold harmless and indemnify the Tiger League Football Program, its representatives, agents, and/or
servants against any loss, damages or costs of whatsoever nature which the participant or the undersigned, their representatives, agents, and/or
servants may suffer as a result of any action, claim or demand the undersigned or by any other person on behalf of or for the benefit of the participant
or the undersigned.
THERE WILL BE NO REFUNDS ISSUED AFTER THE FIRST DAY OF PRACTICE DUE TO INSURANCE FEES.
NAME OF PARTICIPANT_________________________________________________________________________________________________
PARENT OR GUARDIAN_________________________________________________________________________________________________
ADDRESS______________________________________________________________________________________________________________
HOME TELEPHONE__________________________________________________________________CELL PHONE_______________________
MOTHER’S EMPLOYER_______________________________________________________________ TELEPHONE______________________
FATHER’S EMPLOYER________________________________________________________________ TELEPHONE_____________________
MEDICAL INSURANCE COMPANY_____________________________________________ POLICY NUMBER_________________________
DOCTOR PREFERENCE_________________________________________________________________TELEPHONE_____________________
HOSPITAL PREFERENCE________________________________________________________________________________________________
In the event of accident or illness concerning the above-named child, the representatives of Tiger League Football, will use its best effort to
contact the parent immediately. In the event the parent is not immediately available, the representatives of Tiger League Football is authorized to
secure such medical attention and care for the child as under the circumstances to the representative may see proper, and if reasonably possible, the
above-named preferences shall be adhered to. The parents or guardian shall assume full responsibly for all medical bills, doctor bills, and hospital
bills, it being understood and agreed that pursuant to the Consent, Waiver and Release Agreement, Tiger League Football, its representatives, agents,
and/or servants shall not be responsible or liable for any injuries, sickness or other medical problems of the above-named child. THE TIGER
LEAGUE FOOTBALL PROGRAM’S INSURANCE DOES NOT COVER ILLNESS OR INJURY OF ANY CHILD, IT BEING THE
PARENT’S RESPONSIBILITY TO FURNISH SUCH INSURANCE AS THE PARENT MAY DESIRE. THE TIGER LEAGUE
FOOTBALL INSURANCE IS ONLY SUPPLEMENTAL AFTER THE PRIMARY INSURANCE HAS BEEN USED, AND IS LIMITED
TO INJURIES WHICH OCCUR DURING PARTICIPATION IN THE TIGER LEAGUE FOOTBALL PROGRAM.
ANY PARENT WHO DOES NOT RETURN TIGER LEAGUE ISSUED FOOTBALL EQUIPMENT TO THEIR CHILD’S
COACH MAY BE SUBJECT TO PROSECUTION FOR THEFT OF THAT EQUIPMENT FROM THE TIGER LEAGUE FOOTBALL
PROGRAM.
PERMISSION FOR TREATMENT
My permission is granted for the sponsors of Tiger League Football to obtain necessary medical attention in case of sickness or injury to
my child.
I, the undersigned, do hereby verify that the above information is correct, that I understand the insurance coverage provided by Tiger
League Football as described above, and that I understand that I must return the football equipment issued to my child by Tiger League Football to
the coach of my child’s team.
SIGNATURE:__________________________________________________
DATED THIS _________ OF AUGUST, 2012
7.26.12