Name: Graduation Year:

Address: City State Zip

Home Ph: Cell Ph:

e-mail:

Parents name Parent Ph:

School

Coaches Name Coaches Ph:

Coaches email:

Primary Position: Secondary Position:

Compression Shirt size L XL XXL XXXL XXXXL

DEADLINE FOR PRE-REGISTRATION POSTMARK IS MAY 21 - DO NOT MAIL ANY PAYMENTS OR REGISTRAIONS AFTER MAY 21st. NO MAIL IN REGISTRATIONS WITH POSTMARKS AFTER MAY 21 WILL BE PROCESSED.

PLEASE HAND CARRY:   $10 cash or money order tax deductible donation and registration form
Arrive by 7:00 for walk in registration.

Waiver and Release of Liability

I, parent or legal guardian of the above named athlete, agree to waive any claims against, or hold responsible, Pacific Islands Athletic Alliance (PIAA), Saint Louis School, sponsors, athletic trainers, staff, volunteers or sponsors of this event in the event of accident or injury to my son.
As parent or guardian:

1) I confirm and agree my son is in and will be in good physical condition and physically capable of participating in this event.

2) Accidents and injuries, including cardiovascular stress and violent physical contact, may occur in these activities
without fault or negligence by any of the parties involved;

3) Participation in these activities can result in serious, severe injury and even death;

The use of equipment provided may involve risk or injury, especially if the equipment is not properly used, and it is
mine and my sons individual responsibility to learn its proper use;

4) I am solely responsible for assessing whether my sons participation in these activities is safe or suitable based on
his individual experience, skills, and abilities; I assume full responsibility and liability for injury or harm which occurs
to my son as the result of any lack of care, expertise or experience on my part;

5) As parent I am allowing my sons participation in these activities is with full knowledge of the risks involved;

. WITHOUT PARENT  OR LEGAL GUARDIAN SIGNATURE, YOU WILL NOT BE ABLE TO PARTICIPATE!

Parent Name (Please Print)________________________________________Date___________

Parent Signature______________________________________________________________