I, the undersigned parent or legal guardian of the above-named participant ("participant") on behalf of participant, our heirs, and myself assigns and next of kin, hereby agree as follows:

EMERGENCY AUTHORIZATION: I hereby authorize each of the directors, volunteers, and/or other officials of Junior Flag-Football League, Inc ("JFL") to consent to medical, surgical or dental examination and/or treatment.

CONSENT: By registering the participant, I give my permission to allow the JFL, Junior Flag-Football League to post photographs and video of the participant(s) and myself or promotional material including the web.

ACKNOWLEDGEMENT OF RESPONSIBILITY TO SUPERVISE AND HOLD HARMLESS: I acknowledge that it is my responsibility alone to supervise the participant during the entire event. I hold the Junior Flag-Football League, JFL and it's directors, coaches and facilitators harmless for any injury to myself or the participant and I will indemnify Junior Flag-Football League, JFL and it's directors, coaches, Sheridan Park, Ping Tom Park, Chicago Park Districts, City of Chicago and facilitators for any claim, which may be assessed or filed.

DISCLAIMER, ASSUMPTION OF RISK AND WAIVER: I acknowledge that participation in Junior Flag-Football League necessarily involves risk of injury including; severe, permanent physical injury including bruises, scrapes, strained, sprained or torn muscles, tendons or ligaments, broken bones, dislocations, concussion, brain damage, nerve and spinal cord injury, paralysis and death. I willingly and voluntarily accept and assume all such risk, on behalf of the participant and myself and I warrant I have the authority to do so.

REFUND: Refunds are not eligible after May 15. Credit for future programs, leagues and or services will be valid for 12 months after purchase.

I HAVE READ THE ABOVE EMERGENCY AUTHORIZATION, DISCLAIMER, ASSUMPTION OF RISK AND WAIVER AND THE ACKNOWLEDGEMENT OF RESPONSIBILITY TO SUPERVISE AND HOLD HARMLESS. I FULLY UNDERSTAND THE TERMS OF EACH, UNDERSTAND THAT I AND PARTICIPANT HAVE GIVEN UP SUBSTANTIAL RIGHTS BY MY SIGNING THIS FORM AND AGREEING TO THESE TERMS, AND I SIGN THIS FORM FOR MYSELF AND ON BEHALF OF PLAYER AND AGREE TO THESE TERMS FREELY AND VOLUNTARILY AND WITHOUT INDUCEMENT.