ASHLEY RIDGE MEN’S SOCCER 2017 Alumni Game Registration & Waiver Please scan and email this form back to Coach Nate Harris by January 31, 2017 Requirements for alumni game eligibility: 1. Must have played senior year. 2. Finished your senior year in good standing. 3. Must have graduated from Ashley Ridge High School. Game Day: 3:00 pm; Saturday, February 11, 2016 Name: Street Address: City:
State:
Zip Code:
E-Mail: Graduation Year: Preferred Position(s) T-Shirt Size: Did you play college soccer (if so where?): Spouse’s Name: Children’s Names: I, ___________________________ hereby agree to hold Dorchester 2 School District, of which this school (Ashley Ridge High School) is a part, and their employees, agents, representatives, coaches, volunteers, and board members harmless from any and all liability, action, causes of action, debts, claims or demands of every kind of nature whatsoever which may arise by or in connection with any participation in any activity related to this program. In the event I am injured, become ill and/or need medical attention for any reason, Ashley Ridge High School is authorized to arrange transportation to a medical facility and request treatment. I fully understand that I shall be responsible for all cost of transportation, care and/or treatment. IN WITNESS WHEREOF, the undersigned have voluntarily caused this release of all claims to be executed on the date that appears below. X Player Signature Please fill out and return to: Scanned copies can be emailed to
[email protected] OR Mailed copies should be sent to: Nate Harris Ashley Ridge Men’s Soccer 9800 Delemar Hwy. Summerville, SC 29485
Date