2019 REGISTRATION LINEMAN SELECT DEVELOPMENT PROGRAM IN ALLIANCE WITH Lineman (Invite Only) Development Program 2019 Experience a Rare Opportunity that will Feature a U.S. Based Training Approach with Coaches that have NFL/CFL/NCAA Experience. Athlete Name* First Last Email* Enter Email Confirm Email * Parents please use your email if the athlete is under the age of 18.Home Phone*Cell PhoneBirth Date* Facebook Profile*OPTIONAL: Highly recommended as Scouts are now using social media as a recruiting tool. Please put your facebook page url www.facebook.com/yoururl. Twitter Profile*OPTIONAL: Highly recommended as Scouts are now using social media as a recruiting tool. Please put your twitter page name.Emergency Contact Name*EC Phone*EC Relationship*ATHLETE INFORMATIONHeight*5'05'15'25'35'45'55'65'75'85'95'105'116'06'16'26'36'46'56'66'76'86'96'106'117'0Weight*Current School*Graduating Class*The Year You Will Graduate From High School, For Example: 2013 or if you have graduated just say "Graduated" Football Affiliation(s)*HighschoolNCAFAOVFL *Please put N/A in any box that does not apply to you.Football Position(s)*LTLGCRGRTDEDTNGOLBMLBPlease check off your primary position and then add any other position(s) you also play. (i.e. Normally play DE but will go in at DT)Who invited you to the CFI OL/DL Development Program?* Coach - Brock Flemming Coach - Scott Endicott Coach - Wayne Jacobs (NCQA) Coach - Nick Gregg (NCQA) Coach - Pat Woodcock (EPA) Coach - Donnie Ruiz (EPA) Coach - Seb Lamarche Coach - Hugh Doyle Coach - Dan Massey Coach - Carl Tolmie Coach - Darren Joseph Coach - Steve Glenn Other Google Search Other*If you were invited by another coach/parent/friend please provide their name in this box.PARENTS INFORMATIONParent # 1* First Last Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Home Phone*Cell PhoneReceive Text messages? YES NO Email* Enter Email Confirm Email Work Email Enter Email Confirm Email Second Parent* Same Address Different Address Single Parent Parent # 2* First Last Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Cell PhoneReceive Text messages? YES NO Email* Enter Email Confirm Email Work Email Enter Email Confirm Email Athlete Lives with*BothParent # 1Parent # 2DifferentASSUMPTION OF RISK, and WAIVER AND RELEASE OF LIABILITY* 1. In consideration of being allowed to participate in any way in Canadian Football Institute Inc. athletic/sports program, related events and activities, the undersigned acknowledges, appreciates, and agrees that: 1. The risk of injury from the activities involved in this program 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; and, 2. The risk of unsafe field conditions is significant, and while particular rules, practices, procedures, and league policies may reduce this risk, the risk of unsafe field conditions cannot be eliminated and does exist; and, 3. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, 4. I willingly agree to comply with the stated and customary terms and conditions for participation. If however I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and, 5. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Canadian Football Institute Inc., their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event (“Releasees”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. *By Checking this box we accept all of the above terms and conditions PHOTO and ELECTRONIC MEDIA RELEASE WAIVER* 1. I hereby grant permission to Canadian Football Institute Inc. (CFI) its successors, assigns, licensees, and legal representatives, the irrevocable right to use my name, picture, portrait or photograph on its World Wide Web site, in electronic media (e.g., video, CD-ROM, etc.) or in other printed publications or other forms of promotion without further consideration, and I acknowledge the Canadian Football Institute Inc. right to crop or treat the photograph at its discretion, and waive my right to inspect or approve the finished product, including written copy, which may be created in connection therewith. I hereby grant and convey unto the Canadian Football Institute Inc. all right, title and interest in any and all photographic images and video or audio recordings made by the Canadian Football Institute Inc. during my participation in CFI Activities, including, but not limited to, any royalties, proceeds or other benefits derived from such photographs or recordings. I also acknowledge that the CFI may choose not to use my photo at this time, but may do so at its own discretion at a later date. I also understand that once my image is posted on the Canadian Football Institute Inc. website, the image can be downloaded by any computer user. Therefore, I agree to indemnify and hold harmless from any claims the following: the Canadian Football Institute Inc., the photographer, their offices, employees, agents and designees, including league officers. In witness whereof, I have executed this Conduct Statement, Waiver and Release of Liability, and Photo and Electronic Media Release Waiver this date of my registration. *By Checking this box we accept all of the above terms and conditions I further certify that I am 18 years of age or older.*YesNoParticipants CONFIRMATIONAthlete Signature*Parent Signature**Signature of Parent/Guardian if participant is less than 18 years of age. CFI GEAR* Please select your sizes below for your Swag - included with your registrationAre you a new or returning as a CFI Athlete?*New, this is my first yearReturning AthleteNumber of years returning*First Year ReturningSecond Year ReturningThird Year ReturningFourth Year ReturningCFI - Jersey*LXL2XL3XL4XLCFI - Shorts*LXL2XL3XL4XLPRICINGLineman Development Program 2019 (INVITE ONLY)* Price: $ 600.00 CAD Discount Code EASY PAY PLAN or UPFRONT PAYMENTEasy Pay PlanPay Upfront* If you choose the easy pay plan, there is an additional charge to have your payments spread out over three (3) payments. * please make one selection. If you choose this option we will send you an invoice to pay a $100 "upfront deposit". This will GUARANTEE YOUR SPOT for the 2019 program, ahead of the next recruiting class. ***PLEASE ONLY SELECT NO, IF YOU PREFER TO PAY THE FULL AMOUNT *** Total $ 0.00 CAD Invoicing*Please indicate which email address you would like the invoice sent to.
