Please list all honors received in sports and other school activities, and be specific. List the honor and the year, and if the award is not from your school, list the organization giving you the award and the name of the award (i.e., Hattiesburg Optimist Club Student of the Year, 2021).

We, the undersigned parent(s) or legal guardian(s) of the participant listed above ___________________________________________ (hereinafter “Player”), a member of the 2022 Bernard Blackwell All-Star Football Classic Team for in the consideration of our son to participating in such game hosted by the Mississippi Association of Coaches from December 14 through December 17, 2022, do hereby release the Mississippi Association of Coaches, its officers, directors, members and any other agents or representatives (hereinafter “Releasees”) and hereby hold harmless the Releasees against any and all claims, causes of action, demands, costs, expenses, or any other potential actions asserted arising out of or in any way related to or connected with the participation of our son in the 2022 Bernard Blackwell All-Star Football Classic. We, the undersigned, release the Releasees from any and all claims that may result either from the participation in practices leading up to the 2022 Bernard Blackwell All-Star Football Classic or participation in the game, and transportation to or from the game. Moreover, we do hereby grant permission to the Mississippi Association of Coaches to entertain the above named player during the All-Star week beginning Wednesday, December 14, 2022 until Saturday, December 17, 2022, at the close oft he All-Star activities at Gulfport High School Stadium, Gulfport, MS. We, the under- signed, release the above named parties, their agents, employees and other related persons, including all other Releasees, from any and all claims which may result from the travel and entertainment of the above named player.

We also agree that the released parties shall not be responsible for any illness, disease, injury or other occurrence suffered by the player associated with his travel, entertainment, participation in practice or in the game, and furthermore agree that there shall be no liability to the Releasees herein for any of the above noted acts.

By these presents and in consideration above enumerated, we further covenant and agree that we shall forever re- frain from instituting any action, pressing, collecting or in any way aiding or proceeding upon any and all claims, causes of action, suits and proceedings of any kind at law or in equity which our son or the undersigned ever has, or may have, against any of the Releasees herein arising out of the aforesaid activities, and more particularly participation in practices and the game relating to the 2022 Bernard Blackwell All-Star Football Classic, or any other activity relating thereto.

All participants will be expected to abide by current COVID-19 regulations & guidelines.

I, the undersigned parent(s) and/or guardian(s) of the participant named above, a participant in the 2022 Bernard Blackwell All-Star Football Classic, do understand that the insurance coverage provided for all the participants in this game is known as secondary coverage. This specifically means that my personal insurance company’s policy is the primary coverage for my son and will be considered primary in the event my son suffers an accidental injury requiring medical attention, evaluation and/or treatment during any All-Star Activities from December 14, 2022 to December 17, 2022.

I further understand that the Mississippi Association of Coaches does provide insurance coverage to my son, but such coverage is secondary, specifically meaning that such coverage only becomes applicable after my coverage, if any, has first been utilized to cover the expenses and fees for such medical treatment. Moreover, I have been informed that the coverage provided by the Mississippi Association of Coaches may have certain deductions, exclusions and upper limits so as not to provide full coverage to my son even if the insurance is utilized after exhausting my personal coverage, if any.

I further understand that the Mississippi Association of Coaches provides such coverage for the benefit of the participants in the 2022 Bernard Blackwell All-Star Football Classic and their parents, and such insurance coverage possibly may not cover all bills, expenses and other costs incurred by the participants while participating in the 2022 Bernard Blackwell All-Star Football Classic at Gulfport High School Stadium, Gulfport, MS. Toward that end, I have been placed on notice by the Mississippi Association of Coaches and its representatives that if additional insurance coverage is needed for my son, I should provide such insurance at my own expense. I hereby state that the information provided on the Medical Consent form is the correct name, address and policy number of the present health, accident and hospitalization insurance providing coverage for my son. If such coverage is changed, lapses or terminates for any reason, I hereby agree to update and supplement the information provided and to ensure that the Mississippi Association of Coaches and its representatives are provided with current information relating to insurance up and through the date of the game.