THIRD DISTRICT COACHES ASSOCIATION EL KORAH SHRINERS EAST-WEST ALL STAR FOOTBALL GAME SPORTS MEDICINE INFORMATION AND MEDICAL RELEASE FORM

We, the undersigned, are aware that participation in football can be a dangerous activity involving MANY RISKS OF INJURY. We understand the dangers and risks of participation in practice or competition in football. These include, but are not limited to: Death; Serious neck and Spinal injuries which may result in complete or partial paralysis; Serious injury to virtually all internal organs; Serious injury to virtually all bones, joints, ligaments, muscles, tendons, and other aspects of the musculoskeletal system. Because of the dangers of participating in athletic activities, we recognize the importance of following coaches' instructions regarding playing techniques, training and other team rules, etc and agree the student athlete shall obey such instructions. In consideration of District Three Coaches Association and the El Korah Shrine for inviting the student athlete to participate in the Third District Coaches Association/El Korah Shrine East-West All Star Football Game, we hereby assume all the risks associated with participation and agree to hold the Third District Coaches Association and El Korah Shrine employees, agents, representatives, coaches, athletic trainers, and volunteers harmless from any and all liabilities, action, causes of action, debt, claims, or demand of any kind of nature whatsoever which may arise by or in connection with the student athlete's participation in any activities related to the Shrine East-West All Star Football Game. The terms hereof shall serve as a release and assumption of risk for the student athlete and Parent/Guardian and their heirs, estate, executor, administrators, assignees, and for all the members of our family.