SIGN WAIVER

FALL 2025

WAIVER

First Name

Last Name

Birthday

Month

Day

Year

Phone

Multi-line address

Country/Region

Address

City

Zip / Postal code

Registered Team Name

Jersey Number

I declare that the info I’ve provided is accurate & complete.

I hereby acknowledge this release from liability for accidental injury or illness which I may incur as a result of participating in any physical activity. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this program.

I hereby grant permission to SURREY FLAG FOOTBALL LEAGUE to use photographs and/or video of me in publications, news releases, online, and in other communications related to the mission of SURREY FLAG FOOTBALL LEAGUE.

Full Name

Signature

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