4TH REFEREES CUP

In cooperation with Rizal Football Association (RiFA)

March 7-8, 2015 (Sat-Sun)
ASCOM FOOTBALL FIELD
8:30 AM 4:00 PM
March 7, 2015 (Saturday)
2015 (Sunday)

March 8,

CATEGORIES:
BOYS BORN 2005
BOYS BORN 2003
BOYS BORN 2001
BOYS BORN 1999
BOYS BORN 1997
GIRLS BORN 1997

CATEGORIES:
BOYS BORN 2006
BOYS BORN 2004
BOYS BORN 2002
BOYS BORN 2000
BOYS BORN 1998
MENS OPEN

NOTE: REGISTRATION OF TEAMS UNTIL MARCH 03, 2015,

THURSDAY

REGISTRATION FEE:

YOUTH: 3,000
MENS OPEN : 3,500

TO CONFIRM THE SLOT:

PLEASE DEPOSIT TO BPI BANK ACCOUNT # 8369-2997-36
TEAMS WILL NO LONGER ENTERTAIN AT THE DAY OF THE COMPETATION.
REGULATION:
TEAMS ARE REQUIRED TO BRING NSO BIRTH CERTIFICATE OR PASSPORTFOR
LEGAL PURPOSES
CONTACT PERSONS:
JOHN MICHAEL ESTIAMBA MOBILE # 09361440838
EDWIN S. ALOBIN MOBILE # 09295645710

4TH REFEREES CUP

In cooperation with Rizal Football Association (RiFA)

REGISTRATION FORM
NAME OF TEAMAGE DIVISION
__________________________________________
_________________________________
OFFICIALS TEAM LIST OF PLAYERS
1. ____________________________________
2. ____________________________________
3. ____________________________________
4. ____________________________________
5. ____________________________________
6. ____________________________________
7. ____________________________________
8. ____________________________________
9. ____________________________________
10.____________________________________
11.____________________________________
12.____________________________________

DATE OF BIRTH
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________

CERTIFICATION
1.__________________________________________ Coach/ manager ______________________
team,
Certify that the following information given above is true and correct and that I, and
my players and parents, agree to abide by the tournament rules and regulations
and above all to present ourselves with sporting-like behaviour or be ejected from
the tournament.
SIGNATURE REQUIRED FOR ACCEPTANCE:

___________________________________
____________________________________
Signature over printed name
CONTACT NO. __________________________
______________________________________

Address:

Email:

4TH REFEREES CUP

In cooperation with Rizal Football Association (RiFA)

WAIVER FORM

In consideration of accepting this entry, I hereby waive all claims against the
4TH REFEREES CUP, and all officials of the tournament, from any liability in
connection with activity and for any injury that may occur while competing or
watching this event.
I hereby attest that my teams member are physically fit and sufficiently
prepared for competing in this event.
Further, WE grant full permission for sponsors and Organizers to include
pictures and Videos of my team and players in any legitimate account in
promotion thereof.
CERTIFIED CORRECT BY:
________________________________________
_____________________________________
Signature over printed name

position

Cell: ________________________________________________________________________________
CERTIFICATION AND CONSENT:
NAME OF TEAM
(SCHOOL/CLUB):_________________________________________________________
ADDRESS:
____________________________________________________________________________
WE, (Players, Officials, and Parents) affirm that we are aware of our physical
condition, that we are voluntarily participating in the 4TH REFEREES CUP, are
aware that such participation may result in possibly injury as a result of the nature
of the sport, and that we are assuming any risk that may be involved in the sport. In
addition, we do hereby release the, PFF, Weekend Organizers, PHILIPPINE ARMY
COMMAND, and NCOIC of ASCOM FOOTBALL FIELD, of any and all responsibility of
liability in case of any personal injury sustained by us or damage of property of
others caused by us while participating in the 4TH REFEREES CUP. I have read

and understand the above statements and will carry them out to the best of my
abilities.
Name: ______________________________________
______________________________
Signature: ___________________________________
________________________________

Position
Date

GOOD LUCK !