Click “File” then click “print” to print this form. Then have your parent or legal guardian to fill it out and sign it. Make sure you bring it to the clinic or you can fax to: 1-877- 835-9934.


THE FIELD GENERALS:

OPERATION LEVEL PLAYING FIELD, INC.
QUARTERBACK YOUTH FOOTBALL CLINIC

CONSENT AND WAIVER OF LIABILITY FORM
(PLEASE PRINT OR TYPE)

PARTICIPATION’S INFORMATION
NAME: ____________________________________
ADDRESS: _________________________________
CITY: _____________________________________
STATE: ____________________________________
TELEPHONE: (         ) ________________________
This is a general consent to participate and release of liability agreement willingly and voluntarily entrée into between The Field Generals: Operation Level Playing Field, Inc., (“The Field Generals”) a Georgia profit corporation and, ______________________________________ (“participant”) individually and through his parent/guardian.
The participant, parent/guardian agrees as follow:


1. GENERAL RELEASE AND DISCHARGE

We the undersigned participant, parent / guardian on behalf of himself, and his dependents, ancestors, heir, executors, administrators and assigns do execute the within agreement, acknowledging and granting the participant permission to participate in the Field General Youth Clinic on February 4, 2006 at Oakland Yards 5328 Highland Waterford, Michigan 48327 ph: 248-673-0100. The participant, parent / guardian, on behalf of him and dependents, ancestors, heirs, executors, administrators, and assigns, hereby covenants not to sue and fully releases and discharge the Field General, cosponsor, volunteer or affiliate of The Field Generals, and present, and each of them, as well as its directors, officers, agents, employees or any other person associated with The Field Generals, and each of them, with respect to and from any all claims demand rights, liens, agreements, contracts, contracts, actions, suits and causes of action, cost, expenses, damage and any other liabilities and claims of whatever kind or nature in law or in equity, whether now known or unknown, whether or not concealed or hidden, and except as limited by law, to arise in the future, which participant may now hold or own or have any right to as against The Field Generals, arising out of in a way connected with participation with The Field Generals, arising out of or in a way connected with participation with The Field Generals Youth Clinic. This GENERAL RELEASE intended to include, but is not limited to, a release of all claims arising out of participation, occurrences, or omissions, or any other loss, damage or injury whatever, resulting from any alleged act or omission by on the part of The Field Generals or any person, firm, or association related to it including but not limited all claims arising out of any negligence, or any other cause of action and any and all claims under any other applicable federal or state law.


2. SEVERABILITY

If any provision of this agreement or the application thereof is held invalid, the invalidity shall not affect other provisions or applications of this Agreement which can be given effect without the valid provisions applications and to this end the provisions of the Agreement are declared to be severable.


3. CHOICE OF LAW

This Agreement shall be deemed to have been executed and delivered within the state of Texas, and the rights and obligation of the parties hereunder shall be construed and enforced in accordance with, and governed by the laws of the state of Texas without regard to principles of conflict of law.


4. COUNTERPART EXECUTION

This Agreement may be executed in counterparts, and each such counterpart, when executed, shall have efficacy of a signed original.


5. FULL UNDERSTANDING AND VOLUNTARY ACCEPTANCE

In entering into this Agreement the parties represent that they have relied upon the advice of their own counsel or attorneys, and that the terms of this Agreement have been completely read and explained to he and the terms are fully understood.

IN THE WITNESS WHEREOF. The undersigned have executed this Agreement on this day, January 2006.


PARTICIPANT

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(Signature)

PARENT / GUARDIAN

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(Please print)

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(Signature of parent/guardian)

TELEPHONE

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