Sample PDF #3

What will you be participating as?*

Player
Manager

PLAYER ACCEPTANCE

Player Name*

First Last

Player Email*

High School*

High School Coach*

First Last

Please Select One (Athlete):*

Yes- I accept the invitation to play in the 2013 Mississippi/Alabama All-Star Football Classic to be played Saturday, December 15, 2013, in Montgomery, Alabama. I agree to arrive in Montgomery on Monday, December 10, 2013, to begin the required practice (transportation to Montgomery will be provided and arranged by the Mississippi Association of Coaches).
No- I decline the invitation to play in the 2013 Mississippi/Alabama All-Star Football Classic to be played Saturday, December 15, 2013, in Montgomery, Alabama.

Please Select One (Parent):*

Yes- I approve of my son's participation in the 2013 Mississippi/Alabama All-Star Football Classic.
No- I disapprove of my son's participation in the 2013 Mississippi/Alabama All-Star Football Classic.

MANAGER ACCEPTANCE

Manager Name*

First Last

Manager Email*

High School*

High School Coach*

First Last

Please Select One (Manager):*

Yes- I accept the invitation to participate as a Manager in the 2013 Mississippi/Alabama All-Star Football Classic to be played Saturday, December 15, 2013, in Montgomery, Alabama. I agree to arrive in Montgomery on Monday, December 10, 2013, to begin the required practice (transportation to Montgomery will be provided and arranged by the Mississippi Association of Coaches).
No- I decline the invitation to participate as a Manager in the 2013 Mississippi/Alabama All-Star Football Classic to be played Saturday, December 15, 2013, in Montgomery, Alabama.

Please Select One (Parent):*

Yes- I approve of my son's participation in the 2013 Mississippi/Alabama All-Star Football Classic.
No- I disapprove of my son's participation in the 2013 Mississippi/Alabama All-Star Football Classic.

PLAYER/MANAGER INFORMATION

Full Name*

First Last

Name you prefer for Publicity/Program

i.e. Robert, Robby, Bob (No Nicknames)

Birth Date*

Age*

Complete Home Mailing Address*

Street Address City State ZIP Code

Home Phone (including area code)*

Cell Phone (including area code)*

Height*

Weight*

T-Shirt Size*

Shorts Size*

Father Name*

First Last

Mother Name*

First Last

High School Team Name:*

ex. Eupora Eagles

High School Head Coach*

First Last

Coach's Phone: (including area code)

Coach Email*

FOOTBALL CAREER

What awards of distinction have you received?*

ex: All-Region, All-District, All-State, MVP

Who is your Football Hero?*

Tell about your greatest thrill in Football?*

List any school, region or state records you hold in football:

List other high school sports played, years played and any honors, awards or records:

SCHOOL

What are your favorite subjects?*

Academic honors earned:

What are your career goals or the field of study you'll pursue in college?*

What College do you plan to attend?*

If undecided, colleges you are being recruited by:

MISCELLANEOUS

What is your superstition, if any?

Are you related to or descended from anyone of particular prominence in any field of sport? If so, please give details and your relationship.

Hobbies other than sports:

Name of your hometown newspaper:

RELEASE AND PERMISSION FOR MINOR TO PARTICIPATE IN ATHLETIC EVENT

The undersigned, being the parent(s) and/or legal guardian(s) of minor (listed previously), a minor, (hereinafterreferred to as the Player), and being the person(s) fully responsible for the health and well-being of the Player in theevent that his agreement is legally necessary to the binding effect of this release, do, for and in consideration of thePlayer being allowed to participate as a player in the 2012 Mississippi/Alabama All-Star Football Classic (hereinaftercalled the Game), to be played at Cramton Bowl in Montgomery, Alabama, on December 15, 2012, and to alsoparticipate in the functions and activities leading up to and preceding the Game, hereby acknowledge and agree tothe following:

1. The undersigned does hereby consent(s) to the Player playing in the Game and participating in practices and allfunctions and activities surrounding the Game.

2. The undersigned understands that the Player will be housed, at a site in Montgomery to be determined later,during the week of December 10 - 15, 2012. It is further understood that the housing provider is only providingspace and that all guidelines set forth by the Sponsor of the Game, AHSAA (hereinafter called the Sponsor of theGame) will be enforced within the lodging rooms and on the campus, or at related areas and facilities. In addition,the undersigned understands that the housing provider and other facility providers accept no responsibility for theoverseeing or chaperoning of the Player or any of the participants or staff members, nor does it assume or accept any liability for personal injury, loss of life, or damage to personal property.

3. The undersigned fully understands that practice facilities will be provided by Faulkner University and HuntingdonCollege during the week of December 10 - 15, 2012. It is further understood that these institutions are only providing practice space for the Game and that all guidelines set forth by the Sponsor of the Game will be enforced on the practice fields and on the campuses. In addition, the undersigned understands that Faulkner University and Huntingdon College accept no responsibility for the overseeing or chaperoning of the Player or any of the participants or staff members nor do they assume or accept any liability for personal injury, loss of life, or damage to personal property.

4. The undersigned understands that services, including medical, transportation, food, entertainment, coaching,equipment supply and the like, will be provided to the Player by individuals and organizations to be selected by the Sponsor of the Game. It is further understood that these individuals and organizations accept no responsibility for and do not assume or accept any liability for personal injury, loss of life, or damage to personal property.

5. The undersigned fully understands and is aware of the risk of damage or loss of property, personal injury ordeath involved in playing in the Game and in participating in the functions and activities surrounding the Game,including travel. Being fully aware of the risk involved, the undersigned do, for the undersigned themselves, and forand on behalf of the Player himself, and for their personal representatives, heirs, executors and administrators,agree to forever discharge, release, defend, covenant not to sue, hold harmless and indemnify the following: TheCity of Montgomery, County of Montgomery, Faulkner University, Huntingdon College, Jackson Hospital, JacksonHospital Sports Medicine, Montgomery Lions Club, the Central Alabama Sports Commission, the Alabama High School Athletic Association, the Alabama High School Athletic Directors and Coaches Association, the Mississippi Association of Coaches, the Montgomery County Public School System and any public or private school providing practice facilities, Encore, the coaches of the All-Star game teams and staff members, and each of the officers, agents, directors, trustees, Boards of Directors, Boards of Trustees, servants, employees, team physicians, team trainers, contractors and subcontractors of the foregoing, from and against any and all damages, including attorneys' fees and expenses, owing or payable on account of any and all claims, demands, actions or causes of action of any kind or nature arising out of or on account of any act, or failure to act, of any person, including the Player, and occurring during the playing of the Game, or while participating in activities and functions surrounding the Game, and that result in personal injury, death, or property damage, whether such personal injury, death or property damage occurs to the person or property of the Player, with or without his contributing fault, or to the person or property of another and on account of or caused by a relevant act or failure to act of the Player himself.

Athlete Attestation*

By clicking here, I attest to reading and understanding the 'Release and Permission' information listed above.

Parent Attestation*

By clicking here, I attest to reading and understanding the 'Release and Permission' information listed above.

EMERGENCY AND HEALTH INFORMATION

Parent or Guardian Name*

First Last

Relationship*

Parent or Guardian Email*

Address*

Street Address City State ZIP Code

Home Phone (with area code)*

Cell Phone (with area code)*

Business Phone (with area code)

EMERGENCY CONTACT

Name of the closest relative or friend to be contacted in case of emergency if parents/guardian cannot be reached.

Emergency Contact*

First Last

Relationship*

Home Phone (with area code)*

Cell Phone (with area code)*

Business Phone (with area code)

Family Doctor*

Doctor's Phone (with area code)*

Do you have insurance?*

Yes
No

Insurance Company*

Policy Number*

Group Number*

Does your son have any Unusual Health Conditions:*

Select all that apply:

Diabetes
Heart Condition
Convulsive Seizures
Alergies
Other

'Other' Please list:*

Please list Allergies*

In case of emergency, Game Committee is authorized to:*

Select all that apply:

Call above named Doctor
Call team doctor if family doctor is not available
Take athlete to local hospital
Other

SIGNATURES

Your signatures below attest to your understanding of the information collected in this form. An email will be sent with copies of this information.

Athlete/Manager Signature*

Parent Name

First Last

Parent Signature*

All-Star Acceptance

PLAYER ACCEPTANCE

MANAGER ACCEPTANCE

PLAYER/MANAGER INFORMATION

FOOTBALL CAREER

SCHOOL

MISCELLANEOUS

RELEASE AND PERMISSION FOR MINOR TO PARTICIPATE IN ATHLETIC EVENT

EMERGENCY AND HEALTH INFORMATION

EMERGENCY CONTACT

SIGNATURES