SELECT ATHLETE 2019 REGISTRATION Simply fill out the form below and you’ll be registered into our 2019 program. IN ALLIANCE WITH Select Athlete Development Program 2019 Parents and Athletes, get ready for an experience that puts the athlete in the spotlight and where our coaches are more like mentors. A program where we help young athletes get better (on and off the field), improve their skills all while having fun. This is in partnership with University of Ottawa Gee-Gees football program, one of the best QB Coaches in the country in NCQA (Wayne Jacobs) along with two of THE PREMIERE WR/DB Coaches - Pat Woodcock & Donnie Ruiz from EPA (Elite Performance Academy) . Your child will be Coached by EX-CFL, NFL, NCAA and current CIS players. Athlete Name* First Last Email* Enter Email Confirm Email Birth Date* Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Home Phone*Cell PhoneFacebook 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)*OLDLLBDBQBRBWRPlease check off your primary position and then add any other position(s) you also play. (i.e. Normally play WR but will ALSO play DB)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 UOttawa Gee-Gees Google Search Other 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 & 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 & 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.* Yes No Participants 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 registrationCFI - Performance T-Shirt*YSYMYLYXLSMLXL2XL3XL4XL* We will try our best to provide you with the size you requested, however , supplier demand may vary and the sizes you receive could be different.CFI - Player Shorts*YSYMYLYXLSMLXL2XL3XL4XL* We will try our best to provide you with the size you requested, however , supplier demand may vary and the sizes you receive could be different.PRICINGAge Category*7-1112+*This selection is to determine the appropriate program to be place in. Select Athlete Junior Development Program 2019* Price: $ 300.00 CAD *Ages 7-11Select Athlete Senior Development Program 2019* Price: $ 600.00 CAD *Ages 12+Discount Code EASY PAY PLAN or 1-TIME PAY (RESERVE YOUR SPOT)*Yes, please set me up for recurring paymentsNo thank you, I would like my PAY UPFRONT discount.* 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. Total $ 0.00 CAD Invoicing*Please indicate which email address you would like the invoice sent to.