MARITIME FOOTBALL LEAGUE 

2011 REGISTRATION FORM
 
TEAM NAME:________________________________
 
NAME:______________________________________ BIRTHDAY D/M/Y:  __________
ADDRESS:__________________________________   AGE ON 31/12/11:___________
                    ________________________________ HEIGHT:__________________
POSTAL CODE:______________________________ WEIGHT:__________________
PHONE:_____________________________________  OTHER  SPORTS PLAYED:
SCHOOL OR JOB :___________________________  _________________________
MEDICARE # :_______________________________ _________________________
E-MAIL ADDRESS:_________________________________
  

REGISTRATION    FEE:

 $_______
T-SHIRT SIZE (CIRCLE ONE)

AS,   AM,  AL, AXL, A2XL, A3XL, A4XL
  
PLAYERS MUST BE AT LEAST 18 ON DECEMBER 31 IN THE YEAR OF PLAY.
PLAYERS GRADUATING FROM HIGH SCHOOL IN JUNE OF THE YEAR OF PLAY ARE ELIGIBLE TO PLAY IN THE MFL.
  
DO YOU HAVE HEALTH INSURANCE THAT COVERS COVERS SPORTS INJURY RELATED COSTS
SUCH AS AMBULANCE, PHYSIOTHERAPY, MASSOTHERAPY, ETC.  ?       ______________
  

I understand that in a contact game like tackle football that injuries may occur. I hereby indemnify, hold harmless and release the MFL, coaches and participants from any and all liability for all claims, demands losses, damage and costs including reasonable attorney’s fees, that arise out of or in connection with any personal injury, property damage, and or other loss suffered by me in connection with participation in the MFL. I acknowledge that I am responsible for any and all medical expenses.
In the event of medical emergency and I am unavailable, I give my consent for whatever procedures are necessary by qualified medical staff. 
  
PLAYER SIGNATURE: _________________________________ DATE: _______________
  
Parental or Guardian Consent and Waiver for ALL players under the age of 18 at date of registration. 

I authorize my son to participate in the Maritime Football League. I understand that in a contact game like tackle football that injuries may occur.  I hereby indemnify, hold harmless and release the MFL, coaches and participants from any and all liability for all claims, demands losses, damage and costs including reasonable attorney’s fees, that arise out of or in connection with any personal injury, property damage, and or other loss suffered by my son in connection with participation in the MFL. I acknowledge that I am responsible for any and all medical expenses.
In the event of medical emergency and I am unavailable, I give my consent for whatever procedures are necessary by qualified medical staff. 
     
PARENT OR GUARDIAN SIGNATURE: _______________________________ DATE: _______________