PUTNAM VALLEY FOOTBALL CLUB REGISTRATION - FALL 2022

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PUTNAM VALLEY FOOTBALL CLUB REGISTRATION - FALL 2022

* Please be sure to fill out all sections of this form and read and sign off on the Registration Policy Statement, Informed Consent and Photo Release statements. Registration is not final until fully completed, signed forms are submitted *


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REGISTRATION AND POLICIES STATEMENT

I assume all risk of personal injury involving this program. Acting on the behalf of my child, I do here by release the Putnam Valley Football Club, Putnam Valley Parks and recreation Dept., Putnam Valley Central School Distract, their staff, instructors, coaches and volunteers of liabilities including’s claims and suits of law or equity, for any injuries which results directly or indirectly by reason of participation in this football program, I am aware that the Putnam Valley Football Club does not provide any accident insurance.

INFORMED CONSENT STATEMENT

I hereby give permission for the child listed above to participate in the 2021 Putnam Valley Football Club season and my child is in good health, and does not have any health related restraints that would not allow him/her to participate in such physical activity. It is my understanding that my child will comply with the policies of the Putnam Valley Football Club and the coaches / instructors. My child and I are aware that participating in the Putnam Valley Football Club is a potentially hazardous activity. We assume all risk associated with participation in sports or activity. I acknowledge that even with the best coaching, supervision, and observance of rules. Injuries are still possibility. I also understand that I have to either pick my child up or arrange to have transportation for my child at the beginning and end of each practice, game or activity.

Further, I authorize the coach / instructors to provide emergency treatment of any injury or illness my child may experience if qualified personnel consider treatment necessary and perform the treatment. This authorization is granted only if I cannot be reached and a reasonable effort has been made to do so.

PHOTO RELEASE STATEMENT

I Hereby grant permission for Video recordings and digital photographs to be taken of my child as part of his or her participation in the Putnam Valley Football Club. I Understand that the recordings and images will be collected for the use in our Year end Program and team video for our club.

I authorize Putnam Valley Football Club to use my child’s images on its websites and or in printed promotional materials without further consideration and I knowledge Putnam Valley Football Club right to treat the media (such as cropping) at its discretion.

I also acknowledge that Putnam Valley Football Club may choose my child’s image at this time, but may do so at a later date.

I understand my child’s image is posted on the Putnam Valley Football Club website the image can be downloaded by a third party. I agree that I will not hold Putnam Valley Football Club responsible for any harm that may arise from such unauthorized reproduction.

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