TownBeef TACKLE FOOTBALL INJURY WAIVER FORM For League Admins
Name_______________Board Possition:_____________________Signature_____________________Date:____________________
By signing this agreement I, as a board member of the TownBeef football league guarantee every player stepping on the field has signed the form below.
For clarity, I guarantee there is a roster system for monitoring and confirming every player has signed the waiver below.
I, ______________________________________, being of sound mind and body
acknowledge that I am engaging in tackle football games. I affirm that I am in
good physical condition and do not suffer from any disability that would
significantly prevent or limit my participation in any tackle football games. I
also certify that I have my own Health Insurance with ____________________ (INS.
Company) and am 18 years of age or older.
I understand and am fully aware of the fact I will be involved in a Full CONTACT
SPORT involving hitting, throwing, running, blocking, tackling and all other
tangible type acts that are used in a tackle football game. I understand that
these above mentioned acts can and probably will cause me bodily harm.
In the event I am injured or suffer any short-term or long-term physical harm, I
release TownBeef LLC it's owners officers and assets, all referees, schedule makers, other players and participants, web
designers, message board members, towns that I’m playing in and their fields
from any and all liabilities now or in the future including but not limited to
medical, hospital, paramedic or ambulatory care.
I release all involved in the TownBeef Community, its players, web sites, web
site updaters and designers, web hosting and server companies in which the
TownBeef.com site resides, referees, videographers, photographers, fans, owners
of fields and or parks along with the townships they are located in from
liability for any and all injuries sustained now or in the future, including,
but not limited to pulls or tears (muscles, ligaments or tendons), muscle
strains, broken bones, impalements, joint dislocations, hyperextensions of bones
and joints, defenestration, decapitation, ankle, knee, hip, lower back,
shoulder, elbow, wrist, finger or toe injuries, partial or total dismemberment,
heart attacks, strokes, bear attacks, loss of vision, concussion, fatalities,
dental trauma, amnesia, death, emotional scarring, or any other injury or
illness however caused, occurring during or after my participation in any
TownBeef Tackle Football game. Any injury short or long term that I
receive during a TownBeef no pads tackle football game or any type of football
game I'm 100% aware that I'm 100% responsible.
I understand that TownBeef is a football community devised by myself and my piers (other participants). My participation in schedule making, game write ups, video taping or photographing, refereeing, posting threads in a message boards and all other types of participation enable TownBeef tackle football games to be possible. I understand this is not a league or an organization but just some individuals wanting to participate in pick up football games just as they would a pick up basketball game, soccer game, or volley ball game.
I understand that by being a part of the
TownBeef football league that my still photos and videos shot during TownBeef
functions can appear on TV, Youtube, Newspapers and any other types of coverage
and release these rights to TownBeef LLC.
I give TownBeef and or it's affiliated producers and networks the right to
display images or video of myself during TownBeef functions without compensation.
I hereby affirm that I have read fully, understand and agree with the above
statements.
Signature: ________________________________________________ Date:
_____________________
Contact Information:
Name: ___________________________________________________ DOB:
____________________
Address:
____________________________________________________________________________
Phone: (Home) _____________________________ (Mobile)
________________________________
Email Address:
_______________________________________________________________________
Emergency Contact Information:
Name: __________________________________________ Relationship:
_______________________
Address:
____________________________________________________________________________
Phone: (Home) _____________________________ (Mobile)
________________________________