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NFL Players Association Football & Fitness / Ean Clough Memorial Football Clinic Join Former Gilbert Football Players For a fun, noncontact football clinic All participants will receive a gift bag with items donated by the NFL Players Association Random drawing for autographed memorabilia FOR BOYS AND GIRLS BETWEEN THE AGES OF 6-12 Friday, July 17, 2009 | 6:00 PM-8:00 PM Gilbert School (Van Why Field) 200 Williams Ave. Winsted, CT 06098 Cost $10 per participant All of the proceeds will go to the Ean Clough Memorial Scholarship Fund PleaseWillis make all checks payable to : Ean Clough Memorial Scholarship Fund For further information contact Whalen @ 954.802.6665 · Please fill out the attached release / waiver along with a check for $10 and bring it with you on the 17th (we will collect them @ the clinic). In return for being allowed to participate in the “EanClough Memorial Football Clinic" held on Friday, July 17, 2009 at the Gilbert School field (the "Event"), I release and agree not-to-sue the NFL Players Association, NFL Players, Inc., the Gilbert School, Winsted Parks and Recreation and each of their officers, directors, employees, sub-contractors, sponsors, agents and affiliates (collectively the "Releasees") from all present and future claims that may be made by me, my family, estate, heirs, or assigns for property damage, personal injury, or wrongful death arising directly or indirectly as a result of my participation in the Event, including, without limitation, my use of transportation services to and from the Event, wherever, whenever, or however the same may occur. I understand and agree that the Releasees are not responsible for any injury or property damage arising out of the Event, including, without limitation, my use of transportation services to and from the Event, even if caused by their ordinary negligence. I understand that participation in the Event involves certain risks, including, but not limited to, serious injury and death. I am voluntarily participating in the Event, and all related activities, with knowledge of the danger involved and agree to accept all risks of participation. I consent to administration of first aid and other medical treatment in the event of injury or illness. I also agree to indemnify and hold harmless the Releasees for all claims arising out my participation in the Event, including, without limitation, my use of transportation services to and from the Event, and all related activities and any medical treatment. I understand that this document is intended to be as broad and inclusive as permitted by the laws of the state in which the Event is taking place and agree that if any portion of this Agreement is invalid, the remainder will continue in full legal force and effect. I further agree that any legal proceedings related to this waiver will take place in the District of Columbia. Name of Participant (First and Last Name):_________________________________ Phone Number __________________________________ Email address:__________________________________ Address: ________________________________________City: ____________________________ State ____________ Zip ________________ (If Participant is under 18 years of age, the parent(s) or guardian(s) must execute in addition to the above, the following waiver). Parent/Legal Guardian if Participant is Under Age 18I am the parent or legal guardian of the Event participant. I am of legal age and am freely signing this agreement on behalf of the Event participant. I have read this form and understand that by signing this form, I am giving up legal rights and remedies on behalf of myself, the Event participant and his/her family, estate, heirs, and/or assigns. Signed: _________________________________________________________ Relationship to Minor: ___________________________________________