NEW MELLE SPORTS & RECREATION, INC.

-2008 LIABILITY WAIVER-

ASSUMPTION AND ACKNOWLEDGMENT OF RISKS

AND RELEASE OF LIABILITY AGREEMENT

In  consideration  of  my child being  allowed  to  participate  in  the  New  Melle Sports & Recreation, Inc.  Football Program (a/k/a  the Jr. Viking Football Program),  its  related  events  and  activities,  the  undersigned,  acknowledges and  agrees  that :

1)    The risk of  injury from the  activities  involved  in  this  football program for my child is  significant,  including  the  potential  for  permanent  paralysis  and  death, and  while  particular  rules,  equipment,  and  personal  discipline  may  reduce  this  risk,  the risk  of  serious  injury  does  exist;

2)    I  KNOWINGLY  AND  FREELY  ASSUME  ALL  SUCH  RISKS, both  known  and  unknown,  EVEN  IF  ARISING  FROM  THE  NEGLIGENCE  OF  THE  RELEASEES (as later defined) or  others  and  assume  full  responsibility  for  my child’s  participation;

3)    I  willing   agree  to  comply  with  the  stated  and  customary  terms  and  conditions  for  my child’s participation.  However, if  I  observe  any  unusual  significant  hazard  during  my  presence  or  my child’s participation, I  will  bring  the issue to the  attention  of  the  nearest  official  and coach immediately; and

4)   I, for  myself  and  on  behalf  of  my  heirs,  assigns,  personal  representatives  and  next  to  kin , HEREBY  RELEASE, INDEMNIFY,  AND  HOLD  HARMLESS  New Melle Sports & Recreation, Inc. (a/k/a the Jr. Viking Football Program), its directors, officers, employees, coaches, officials,  agents, other  participants, any sponsoring  agencies,  sponsors,  advertisers,  and, if  applicable, owners, and  lessors  of  the  premises  used  to  conduct  any related events of the Jr. Viking Football Program (hereinafter, “Releasees”) with respect to ANY  AND  ALL INJURY,  DISABILITY,  DEATH, LOSS OR DAMAGE TO ANY PERSON OR PROPERTY,  whether arising from the negligence of the Releasees or otherwise, to  the  fullest  extent  remitted  by  law.

I certify that I am the legal parent/guardian of the player(s) listed below and that I have legal  authority and  responsibility to execute this document on behalf of the player(s).

PLAYER 1 NAME (Printed):  ______________________

PLAYER 2 NAME (Printed):  ______________________

PLAYER 3 NAME (Printed):  ______________________

PLAYER 4 NAME (Printed):  ______________________

PARENT NAME (Printed): _______________________

PARENT SIGNATURE: ________________________

DATE: ____________