I certify the information on this form is true and correct.


NBJFL ATHLETIC WAIVER AND RELEASE OF LIABILITY
(PLEASE READ BEFORE SIGNING)

(FORM MUST BE SIGNED & HANDED IN TO PARTICIPATE IN THE 2025 SEASON)

In consideration of being allowed to participate in any way in Northern Bergen Junior Football League (“NBJFL”)
athletic participation, related events and activities, the undersigned acknowledges, appreciates, and agrees that:
1. The risks of injury and illness (ex: communicable diseases such as MRSA, influenza, and COVID-19) from the
activities involved in this program are significant, including the potential for permanent paralysis and death, and
while particular rules, equipment, and personal discipline may reduce these risks, the risks of serious injury and
illness do exist; and,
2. 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,
3. 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,
4. I have reviewed and will adhere to all of Governor Murphy’s Executive Orders including Executive Order #149,
The Centers for Disease Control and Prevention (CDC) guidelines and the New Jersey Department of Health
guidelines for Covid-19 in all respects while using municipal facilities or participating in municipal activities; and,
5. I understand I am responsible for
adhering to the rules and regulations as set forth in the 2023 NBJFL Rulebook. Furthermore,
I understands and accepts these rules and will accept all decisions by the league pertaining to its adherence. I will accept all decisions as final; and
6. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE,
INDEMNIFY AND HOLD HARMLESS: NBJFL also known as, Northern Bergen Junior Football League (N.B.J.F.L.)
(“RELEASEES”), their elected board members and/or any coaches, League Representatives, Your Programs elected
officials, commissioners, officers, officials, agents, other participants, sponsoring agencies, sponsors, advertisers.
WITH RESPECT TO ANY AND ALL INJURY, ILLNESS, DISABILITY, DEATH, or loss or damage to person or property,
WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by
law.

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.


COACHES NAME:

____________________________________

SIGNATURE:

____________________________________

DATE SIGNED: _____________________


EMERGENCY PHONE NUMBER:

_______________________