Mens Flag Football League 2014 WAIVER

I, the undersigned, agree to indemnify, defend and hold harmless Pkahi Academy, against any and all damages

to property or injury to, or death of, any person, including property or volunteers of Pkahi Academy
Organization and from any and all claims, demands, actions, suites, or property of any kind or nature. I assume
all risk of injury to my person and property that may be sustained in connection with any activity in and about
the premises. I am in good health and have no physical condition that would prevent me from participating. I
am familiar with the skills required to participate. I further agree to practice and display good sportsmanship at
all times and abides by the player Code of Conduct. I have read the Waiver of Liability and fully understand its
terms, and conditions and meaning.
MEDIA RELEASE: I/we also hereby give permission to Pkahi Academy to film, tape, or otherwise record
my/our childs name, voice, and/or person. I/we understand that these recordings of my/our child may include
news releases to include photographs about Pkahi Academy and other media releases to publicize Pkahi
Academy, and open-circuit (broadcast), closed-circuit, and/or cable television transmission within or outside of
the State of Hawaii in perpetuity. I/we also understand that there will be no financial or other remuneration
for recording my/our child, either for initial or subsequent transmission or playback. Data from applications
will be used for program planning and research purposes only.

BY AFFIXING MY SIGNATURE TO THIS DOCUMENT I UNDERSTAND AND AGREE TO

ALL THE ABOVE.
TEAM NAME__________________________________
TEAM MANAGER______________________________
PLAYER NAME

SIGNATURE

PHONE #

EMAIL

PARENT/GUARDIAN
SIGNATURE if a minor