SELECT YOUR TEAM:*10U TEAM12U TEAM14U TEAM15U TEAMAthlete InformationAthletes Name* First Last Athletes CellAthletes Email* Enter Email Confirm Email Athletes Twitter HandleAthletes Instagram HandleAthletes Shirt Size*Youth SmallYouth MediumYouth LargeAdult SmallAdult MediumAdult LargeAdult X-LargeAthletes Short Size*Youth SmallYouth MediumYouth LargeAdult SmallAdult MediumAdult LargeAdult X-LargeAthletes Glove Size*Youth SmallYouth MediumYouth LargeAdult SmallAdult MediumAdult LargeAdult X-LargeAthletes Birthday* Date Format: MM slash DD slash YYYY Athletes Current Age*Athletes School*Athletes Current Grade*3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th GradeParent InformationParent 1 - Name*Parent 1 - Cell*Parent 1 - Email* Enter Email Confirm Email Parent 2 - NameParent 2 - CellParent 2 - Email Enter Email Confirm Email Credit Card InformationCardholder Name*Credit / Debit Card Number*Card Expiration Date*Card Security Code*Zip Code*Credit Card Authorization* I agree to the payment schedule below.I, parent or guardian of the above named athlete, authorize KB3 FOOTBALL to charge the credit / debit card listed above the KB3 ELITE Monthly Team fee of $95 on the dates listed below. I understand that my information will be saved for additional transactions on my account. Any additional transaction (not listed below) will require additional email authorization by KB3 football. Additional transactions can be but are not limited to Gear, tourney fee and travel tickets. You may cancel this authorization at any time by contacting us. This authorization will remain in effect for the duration of the season or until it is canceled. PAYMENT SCHEDULE: 1. February 5, 2021 2. March 5, 2021 3. April 5, 2021 4. May 5, 2021 5. June 5, 2021 6. July 5, 2021Team Liability Waiver* I agree to the Team Liability Waiver.I, PARENT OR GUARDIAN OF THE ABOVE NAMED ATHLETE HEREBY GIVE APPROVAL TO PARTICIPATE IN ACTIVITIES WITH BLACKMON FOOTBALL LLC. I ASSUME ALL RISKS AND HAZARDS INCIDENTAL TO SUCH PARTICIPATION INCLUDING TRANSPORTATION TO AND FROM THE ACTVITIES, AND DO HEREBY WAIVE, RELEASE, ABSOLVE, INDEMNIFY, AND AGREE TO HOLD HARMLESS BLACKMON FOOTBALL LLC, ORGANIZATION, THE ORGANIZERS, SPONSORS, SUPERVISORS, PARTICIPANTS AND PERSONS TRANSPORTING THE PLAYER TO AND FROM ACTIVITIES, FOR ANY CLAIM ARISING OUT OF AN INJURY TO THE PARTICIPANT, EXCEPT TO THE EXTENT AND IN THE AMOUNT COVERED BY ACCIDENT AND/OR LIABILITY INSURANCE HELD BY BLACKMON FOOTBALL LLC. PHOTO/VIDEO/INTERVIEW RELEASE – I ALSO LAWFULLY GRANT BLACKMON FOOTBALL LLC PERMISSION TO DISPLAY PHOTOS & VIDEOS OF MY CHILD/CHILDREN, ETC FOR POSTIVE AND FAVORABLE PURPOSES. I UNDERSTAND THAT PHOTOS MAY BE USED ON THE WEB SITE OF KB3 FOOTBALL TRAINING. PHOTOS/VIDEOS MAY ALSO BE USED WITH LOCAL MEDIA ADVERTISING, NEWPAPER, MAGAZINE, AND SPORTS STATIONS. I GRANT PERMISSION TO MANAGING PERSONNEL OR OTHER ORGANIZATION REPRESENTATIVES TO AUTHORIZE AND OBTAIN MEDICAL CARE FROM ANY LICENSED PHYSICIAN, HOSPITAL, OR MEDICAL CLINIC SHOULD THE PARTICIPANT BECOME ILL OR INJURED WHILE PARTICIPATING IN ACTIVITIES AT TIMES WHEN NEITHER PARENT IS AVAILABLE TO GRANT AUTHORIZATION FOR EMERGENCY TREATMENT. CommentsThis field is for validation purposes and should be left unchanged.
