2014

TEAM ROSTER AND WAIVER FORM

Team Name*
Team Gender*
Age / Grade:*
Coach/Primary Team Contact*
First Last
Contact Phone*
Contact Email*
Waiver, Trademark and Management:
Each participant and their legal guardian if the player is under the age of 18 must read, agree, and sign the Waiver Form. Participation in this event and its related activities contain risks. By signing this Waiver Form, I release and discharge S.A. Factory of Champions, event sponsors, event organizers, and S.A. Factory of Champions workers, employees and directors from any claims, demands, and causes of action arising from my child’s participation in their events and related activities. I fully understand that the participation in S.A. Factory of Champions Events and Programs contain a risk and that S.A. Factory of Champions (its employees, agents, directors, and owners) are not responsible for any lost or stolen articles of clothing or personal property. Player eligibility for NCAA, collegiate sports and school district may vary. Event organizers are not responsible for determining each player’s eligibility. Contact your coach or athletic director and ask how your eligibility would be affected, if at all, before registering for this event.
List
Player Name Birthdate Parent / Guardian Initial Contact Phone Contact Email*
As Coach/Team Representative, I certify that the information within is correct to the best of my knowledge.
Print Name*
First Last
Signature*

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REV: May 2014

Player Name	Birthdate	Parent / Guardian Initial	Contact Phone	Contact Email*