Your Federal Quarterly Tax Payments are due April 15th Get Help Now >>

2009 MLK Registration Forms by NikFozzar


									                                                                                         Reset Form

                                        TEAM REGISTRATION
                                         Please Print or Type

Team Name_____________________________________________________________________

Coach Name ___________________________________ Contact Number (                 ) _______________

Address ________________________________________________________________________
           Street                     City            State          Zip Code
Fax Number ( ) ___________________ E-mail ________________________________________

Assistant Coach ________________________________ Contact Number (               ) _______________

Address _______________________________________________________________________
             Street                    City           State          Zip Code

Fax Number (    ) ___________________ E-mail _______________________________________

   Fill out the registration form with complete information. All players must be 18 years and up.
   All players must show drivers license, or picture ID are required to check-in. Registration
   must be received by Friday, February 12, 2009. Teams registering after February 12 will be
   charged a $10.00 late fee, if accepted.             Registration forms maybe downloaded Fax (318) 673-7800 or mail completed forms to 7401 Jewella Avenue,
   Shreveport, La. 71108, attn: Kronski Grigsby

   If paying by cashier’s check, money orders or check                General Rules
   (business or personal):                               Tournament information and a complete
   Make payable to: City of Shreveport-SPAR              set of rules will be sent to the coaches the
   You must write your driver’s license number and       week of the tournament. If the information
   expiration date on the check!                         has not been received by Feb. 12, 2010,
                                                         please call Mary Murphy (318) 673-7776
                    Team Roster Form

Team Name:                               Team Gender:

             Name                      Age        Birth Date
                           The City of Shreveport
              Shreveport Public Assembly and Recreation
        Release of Liability and Assumption of Risk Agreement for
                            ADULT SPORTS PARTICIPANT

   1.       This is a release of liability. Read it carefully before signing. By signing this release, you are giving up
            your rights, now and in the future, to sue the City of Shreveport, a municipal entity, its employees and any
            parties that co-sponsors with the Activities (as defined below) (collectively, the “Released Parties”) or to
            expect the Released Parties to be legally responsible or pay for any medical expenses or damages if you
            are injured, killed or become ill, or your belongings are damaged, as a result of your participation in the
   2.       Voluntary Participation. I acknowledge that now and in the future, I am voluntarily choosing to (a)
            participate in one or more sports activities organized, co-organized, operated or administered by the
            Released Parties, and any activities incidental thereto and (b) be present at or use, as applicable,
            facilities, other locations, equipment and/or transportation provided by the Released Parties or others in
            connection with my participation in the activities (the activities in clauses (a) and (b) are referred to
            collectively as the “Activities”.
   3.       Acknowledgment and Acceptance of Risks. I understand that certain risks are inherent in the Activities,
            and that these risks cannot be eliminated, altered or controlled. I understand that the risks that contribute
            to the unique character of the Activities can be the cause of my injury, illness or death or damage to my
            belongings. I voluntarily elect, with knowledge of the risks involved, to participant in the Activities. Now
            and in the future, I acknowledge and willingly assume all risks and hazards associated with the Activities.
   4.       Release. I am an adult of sound mind, aged 18 years or older. In consideration for my being permitted to
            participate in these Activities, as an individual and on behalf of my heirs, executors, agents and assigns,
            (a) I voluntarily agree and promise not to make a claim against, sue or attach the property of the Released
            Parties, and (b) I forever release, waive, discharge and hold harmless the Released Parties for all
            demands, actions or claims of liability arising out of their negligence, fault, recklessness or any other act,
            omission, defect or hazard that causes my illness, injury, death and/or damage to my belongings, now or
            in the future, as a result of my participation in the Activities, if my illness, injury, death or damage to my
            belongings is either related to or incidental to my participation in the Activities.
   5.       Knowing and Voluntary Execution. I have read this document in its entirety. I understand that by signing
            this document, I am assuming all the risks of the Activities now and in the future. I understand that this is
            a release of any and all claims now and in the future. I understand that this is the entire agreement
            between me and the Released Parties and that it cannot be modified or changed in any way by oral
            statements by any Released Parties or by me. I voluntarily sign my name as evidence of the acceptance
            by me of all the provisions in this document and my agreement to be bound by them.

                                    Please Fill Out Completely & Sign
Signature of Participant:
Name (Print Clearly): ___________________________________________________________
City:________________ State: _________ Zip: _________ Email: ______________________
Phone: _____________________ Team Name: ____________________ Date: ____________
Emergency Contact:
Name: __________________________
Relation: ________________________
Phone #: ________________________

To top