Newberry Punt, Pass & Kick Registration
Date: September 21, 2019
Time: 9:00 AM
Location: Setzler Field at Newberry College

FREE to register!
Please complete all of the form below by Friday, September 20.
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Participant Name *
Age *
Date of Birth *
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Gender *
Street Address *
City *
ZIP Code *
Participant's School *
Parent/Guardian Name *
Parent/Guardian Phone 1 *
Parent/Guardian Phone 2 (if applicable) *
Parent/Guardian Email Address
Waiver of Liability/Media Release
As parent and/or legal guardian of the minor child, I understand that the registration and fee, if applicable, for this program does not include the cost of insurance. I AGREE to INDEMNIFY and HOLD HARMLESS the City of Newberry, employees, volunteers, officials, agents, assigns and related affiliates for this event/program/activity (herein referred to as ‘event’) from any and all claims, demands, lawsuits, costs and attorney’s fees arising out of participation in this event. I understand and acknowledge that I have access to event location with right and obligation to inspect prior to each event and agree for the minor child to participate in the ‘as is’ condition.  If I find a hazard or identify that area is unsafe, I have the right to choose for my child not to participate. I agree and consent that photos of my child's participation in this program may be used by The City of Newberry in promotional materials without compensation and without additional approval.  By signing below or via electronic signature below, I hereby affirm that I have read and fully understand the aforementioned and that I agree to the terms and conditions of this Waiver of Liability/Media Release.
Signature of Parent/Guardian *
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