RHS BOYS
AND GIRLS SOCCER ALLUMNI
MAKE PLANS NOW TO ATTEND AND COMPETE AGAIN WITH YOUR TEAMMATES!
Fund raiser for current Boys
and Girls RHS teams. This event will raise money to buy 2 soccer goals for the
McDowell Soccer Complex which cost $1400 each.
RUSSELL HIGH SCHOOL SOCCER SUPER SATURDAY SEPTEMBER 20, 2003
RHS BOYS
VARSITY VS. HOLY CROSS 11:00 AM
RHS
GIRLS JV VS HARRISON CO
1:00 PM
RHS
GIRLS V VS HARRISON CO
2:30 PM
RHS
BOYS.V VS DIXIE HEIGHTS
5:00 PM
PICNIC AND BARBECUE MCDOWELL FIELD 5:30
RHS Alumni Team Pictures 6:30
PM
RHS GIRLS
ALUMNI GAME 7:00 PM
RHS BOYS
ALUMNI GAME 8:30 PM
TO SIGN UP TO PLAY fill in
following information and send e-mail to:
or print and
mail to:
Jack Ditty MD
1 Forest Hills Ct.
Ashland, Kentucky 41101
Name_____________________________ Year graduated______
Address_____________________________________________
city___________________state______________zip__________
Telephone
( )______________e-mail_________________
Name of Health Insurance_______________________________
Emergency contact ________________________phone_________
Fees: Shirt Size (circle one) S M L XL
Alumni Game participant $25.00 _____
(this includes two game tickets, one t-shirt, two dinner tickets,
program, and playing in the game
Souvenir program $ free _____
Alumni Game Team Photo $10.00 _____
Additional Game tickets $ 4.00 _____
Dinner tickets $ 5.00 ______
Donation RHS Girls Soccer Boosters Club $______
Donation RHS Boys Soccer Boosters Club $______
Total ______
Make checks payable to either RHS Girls Soccer Booster Club
Or to RHS Boys Soccer Booster Club
Waiver
All participants in the RHS Alumni Soccer Games are required to assume all risk of participation in the games by signing the general release agreement. The undersigned athlete on behalf of himself/herself and on behalf of Athlete’s personal representatives, assigns, heirs, executors, hereby fully releases, waives, discharges and covenants not to sue the RHS School system, school board, athletic department, coaches, referees, administrative personnel, or individuals who are sponsoring or related to the RHS Alumni Games (collectively “Releasees”) from all liability to the Athlete and his/her personnel representatives, assigns, heirs, executors, for all loss(es) or damage(s) and any and all claims or demands therefore, on account of injury to the Athlete or property or resulting in the death of the Athlete, whether caused by the active or passive negligence of all or any of the Releasees or otherwise, in connection with the Athlete’s participation in the Alumni Games. The Athlete represents and warrants that he/she is in good physical condition and is able to safely participate in the Alumni Game. The Athlete is fully aware of the risks and hazards inherent in participating in the Alumni Games. The Athlete agrees to the use of his/her name and photograph in broadcasts, newspapers, brochures and other media without compensation. The Athlete acknowledges that the entry fee is non-refundable and non-transferable. The Athlete hereby grants to the medical director(s) of the Alumni Games and his or her agents, affiliates and designees, access to all medical records(and physicians) as needed and authorizes medical treatment as needed. The Athlete warrants that all statements made herein are true and correct. Athlete has read the foregoing and intentially and voluntarily signs this release and waiver of liability agreement .
Signature of
Athlete date