Citizens Alliance for Progress, Inc. & Tarpon Recreation Division
“2015 FLAG FOOTBALL TOURNAMENT”
REGISTRATION FORM
Player Full Name
Date of Birth
Address
Phone Number
Age
Shirt Size (Adult or Youth)
Parent/ Guardian Name & Contact Number
Email Address
I, ____________________________________________, for myself, my heirs and personal representatives, and for the minor child _____________________________________________________,
(Parent/Guardian)
(Child’s Name)
and his/her heirs and personal representatives, hereby assume for myself and for said child, all liabilities, risks, injuries and hazards incidental to participation in FLAG FOOTBALL, in
which said child participates, including transportation to or from the said activity. I represent that I am the natural parent or legal guardian of such child and have full lawful authority to
execute this release, waiver and indemnification on behalf of said child, binding myself and said child and the child’s heirs and personal representatives to the undertakings herein set
forth. I acknowledge the fact that this program may/or does involve physical contact or other conditions where injuries may occur. I do hereby waive, release and agree to hold harmless
the CITY OF TARPON SPRINGS & CAP, INC., its officers, agents, employees, the organizers, sponsors, activity supervisors, co-sponsoring organizations and participants for and from
any claim, demand, liability, costs, suits, charges or compensation for loss or injury of any kind arising from the negligence of the CITY OF TARPON SPRINGS & CAP, INC., its agents or
employees and sponsors or activity supervisors, arising from the child’s participation in or presence at said activity. I acknowledge that the CITY OF TARPON SPRINGS & CAP, INC. will
not assume any costs relating to any injury while the child is involved in this activity.
This waiver, release and indemnification is in consideration of the CITY OF TARPON SPRINGS & CAP, INC. or activity sponsor permitting the child’s participation in the activity or program
and in further consideration of the CITY OF TARPON SPRINGS & CAP, INC. not requiring self-funded liability insurance coverage as a condition precedent to the child’s participation in the
activity. I freely and voluntarily assume for myself and the said child all risk of loss or injury arising from the child’s participation in the activity whether due to the child’s negligence, or the
negligence of others. I acknowledge that, absent this release and indemnification, the CITY OF TARPON SPRINGS & CAP, INC. or other sponsor of the activity would not have offered the
child access to the activity because of unacceptable exposure to liability claims or the expense of providing a program that is risk free.
I have read and understood this document and sign it freely and knowingly, intending that it shall be fully operative and effective in all respects and that it waives legal rights to which I
and the child might otherwise be entitled if the child is hurt or suffers loss during the child’s participation in the activity.
YOU MUST CAREFULLY READ THIS DOCUMENT BEFORE SIGNING IT. YOU ARE WAIVING OR RELEASING VALUABLE LEGAL RIGHTS. YOU ARE ADVISED TO SEEK THE ADVICE
OF AN ATTORNEY IF YOU DO NOT FULLY UNDERSTAND THIS DOCUMENT.
Signed this _____________ Day of _________________________, 2015.
______________________________________________________________
Signature Parent/Guardian
Signed in the presence of the following witnesses:
______________________________________________________________
______________________________________________________________
Office Use Only
Coach(s): __________________________________
Division/ Team:
___________________________
Citizens Alliance for Progress and the Tarpon Springs Recreation Division will begin accepting registrations for its
“2015 Flag Football Tournament” now through April 28th at the Tarpon Springs Community Center, from 8:00am
to 7:00pm and at the Union Academy Family Center from 9:00am to 6:00pm Monday through Friday.
Youth ages 5-13 years old

MANDATORY Skill Assessment - Monday, April 27th - 6:00pm (in order to be drafted to a team)

Games will be held Mondays (May 4th, 11th, & 18th) starting at 6:00pm (rolling schedule) in Dorsett Park

Coaches will DRAFT players based on skill level immediately following the Assessment

Teams will be Co-Ed separated by age divisions (5-8 years old and 9-13 year olds)

Youth 14-17 years old may register to become a Coach. Each team will have a “Teen” Coach (2 max./team)

Players & “Teen” Coaches must be registered with CAP, Inc. YD Program

Non - official games will begin Monday, May 4th (deadline for Registration; unless CAP authorized)

Tournament be held Saturday, May 30th starting at 10 am Monday at Dorsett Park
For more information OR if you’re interested in Coaching,
Please contact, Duffy @ 727 942-5628 or Shannon @ 727 934-5881 ext. 20
Registration Packets can be picked up at:
Union Academy Family Center
401 E. Martin Luther King Jr. Dr. ~ Tarpon Springs, FL 34689
or
Tarpon Recreation Center
400 S Walton Ave, Tarpon Springs, FL 34689
The Program is being Co-Sponsored by : City of Tarpon Springs Recreation Division
Youth Co-Ed Flag Football League
th
Starts April 27
Boys & Girls - Ages 5-13 years old
Every Monday Night
6:00pm
Dorsett Park, Tarpon Springs
MANDATORY Skill Assessment - Monday, April 27th, 2015 - 6:00pm
(in order to be drafted to a team)
Registration Packets can be picked up Monday through Friday at:
Tarpon Springs Community Center or Union Academy Family Center
401 E. Martin Luther King Jr. Dr. - Tarpon Springs, FL 34689
FOR MORE INFORMATION, CALL: SHANNON LEE AT (727) 934-5881 EXT. 20