MTF Football Program Application - Home Beneath Our Feet

Applicant Information

Students Name: *

First

Middle

Last

Address: *

Address Line 1

Address Line 2

City

State

Zip Code

Phone: *

Date of Birth: *

School: *

Grade: *

Shirt Size *

In case of an emergency, notify: (List contact information for hours during Day Care -for example work address and phone if at work)

Parent/Guardian

Email

Day Phone

Cell Phone

Parent/Guardian

Email

Day Phone

Cell Phone

Any additional information about the child's behavior and physical, emotional or mental health the staff should be aware of?

Waiver

By submitting this form, I agree to abide by the rules and regulations set forth by Home Beneath Our Feet staff members. I hereby give permission for Home Beneath Our Feet to use for promotional purposes any photos or videos taken of my child while involved in this program. By signing my name below, I am indicating that: this registration form is correct to the best of my knowledge and that child herein described has permission to engage in all prescribed activities except those noted by me. I understand that Home Beneath Our Feet activities have inherent risks and I hereby assume all risks and hazards incident to my participation in all Home Beneath Our Feet activities. I further waive, release, absolve, indemnify, and agree to hold harmless Home Beneath Our Feet, the organizers, volunteers, supervisors, officers, directors, participants, coaches, referees, as well as persons or parents transporting participants to and from activities from any claims or injury sustained during my participation in Home Beneath Our Feet activities.