AMP: Player Registration Form
Thank you for your interest in participating in the upcoming event organized by AMP (Athletic Mentorship Partners) on June 24, 2023. Please take a few minutes to fill out this form to complete your player intake. We are looking for approximately 60 players to participate in this event. We appreciate your cooperation.

Please complete this form prior to June 23, 2023 to be considered to play in our upcoming event.

Note: Teams will be randomly selected day of the event. Players cannot prearrange teams.
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Email *
Seminar & Game Day: Are you available on Saturday, June 24, 2023? *Seminar attendance is mandatory to play.
*
Which team are you interested in joining? *
REFERRAL:  Who referred you to play? (Specific if you're interested in playing on a team with your friends) *due to sponsors wanting to guarantee fairness of the game pre-arranged teams will not be promised.
Personal Information:
First Name *
Last Name *
Phone Number *
An AMP representative will contact you using the provided phone number.
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Zip Code *
Emergency Contact Information:
Please include an emergency person to contact in case of an emergency.
Full Name
Relationship to Player
Phone Number
Wellness & Experience Information:
ABILITY TO PLAY: Are you able to play competitively in Flag Football? *
EXPERIENCE: What is your level of experience in football? *
HEALTH: Do you have any known medical conditions or allergies? If yes, please provide details:
 *
MEDICATION: Are you currently taking any medications or use an inhaler?
*
Additional Comments or Concerns
AMP PARTICIPATION AGREEMENT AND LIABILITY WAIVER:
  1. The Participant acknowledges the risks of Company activities, assuming all potential harm.
  2. The Participant waives liability claims against the Company for any loss or injury while participating in Company activities.
  3. In emergencies, the Participant permits the Company to arrange necessary medical treatment.
  4. The Participant understands the Company does not maintain health, medical, or disability insurance unless agreed otherwise.
  5. The Participant authorizes the Company to use photographs, video recordings, and quotes for promotional purposes.
By checking this box, Participant confirms legal age, understanding, and agreement to all terms.
 *
Required
SELECTION PROCESS: Kindly be aware that a selection process will be conducted before final participation. An AMP representative will contact you using the provided phone number. *Rules of the game & Jerseys will be passed out Saturday Morning at Seminar. 
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