Family Sign Up

Welcome to the Friends of Jaclyn Sign Up page. We are happy you are choosing FoJ for your child. The adoption process begins here! Once we receive your child’s registration form, he or she will be entered into our database where our adoption coordinators will take the time to review your family information and then will respond to you via email or by phone.

Once we determine (along with you) the best team choices, we will begin to seek out the best match possible. We base our match-up decisions not based on a sport, but rather on the entire team, geography, and other influential factors. We have learned that it is not the choice of sport that drives the decision, but rather the group of individuals that make up the team that is more important.

We ask our teams to become involved and truly be able to offer the child their program love, support and friendship for the lifetime of the child. This is not a temporary activity which concludes after the season is over. We truly believe in Adoption for Life at FoJ.

The adoption process can occur and become finalized in a matter of weeks, or can take several months to happen. Every child, family, team and sport is different and we respect all unique aspects of every adoption we work with.

Please know as the parent your input and support is invaluable. Making sure you child is able to get to attend some practices, games and other team activities will ensure a rich and rewarding experience for all. As in all relationships, communication and openness and availability is key.

Fields with marked with an * are required.

Childs Information:
Child's First Name:
Child's Last Name:
Gender:	--None--Male Female
Date of Birth:
Program:	--None--Adopt A Child Safe On The Sidelines (SOS) for Siblings
Type of Tumor:
Primary Treatment Hospital:
Colleges near you:
Carepage Link:
Your Information:
Salutation	--None--Mr. Ms. Mrs. Dr. Prof.
First Name
Last Name
Relationship to child:	--None--Mother Father Guardian Other
Phone
Mobile
Best Time to Contact you:
Email
Address
City
State/Province
Zip
Country
Sibling(s) with DOB:
How did you hear about FOJ?:	--None--Friend School/University Hospital/Medical Care Facilty Event Website Other

WAIVER AND RELEASE OF LIABILITY

PLEASE READ THIS DOCUMENT CAREFULLY. THIS DOCUMENT INVOLVES THE WAIVER OF IMPORTANT LEGAL RIGHTS

I hereby sign this Waiver and Release of Liability of Friends of Jaclyn, Inc. d/b/a Friends of Jaclyn Foundation (“FOJ”) in connection with the Child’s participation in FOJ’s Adopt A Child Program (“Program”). I acknowledge and agree that the Child’s participation in the Program is a wholly voluntary activity and that no one, including FOJ, has in any way compelled or forced the Child to participate in this activity. I am at least 18 years of age. I am aware that the Child’s participation in the Program involves a collegiate athletic team informally “adopting” and interacting with the Child. I am aware that this arrangement will necessitate the Child’s presence in or about areas or locations where sports teams gather, practice or compete, including but not limited to locker rooms, practice fields, and stadiums. I am aware that, despite FOJ’s best efforts to minimize the risk of harm to the Child, the Child’s presence at these locations may pose a risk of mental, emotional or physical injury to the Child. On behalf of myself and the Child, I knowingly assume all risks that the Child may face in the course of his/her participation in the Program, including but not limited to risks of mental, emotional or physical injury or illness arising from his/her presence at these locations.

ON BEHALF OF THE CHILD, MYSELF AND MY HEIRS, ADMINISTRATORS, SUCCESSORS AND ASSIGNS (collectively, the “RELEASORS”), I EXPRESSLY RELEASE FOJ AND ALL OF ITS OFFICERS, DIRECTORS, TRUSTEES, AGENTS, SERVANTS, ADMINISTRATORS, REPRESENTATIVES AND EMPLOYEES FROM ANY AND ALL CLAIMS THAT THE RELEASORS MIGHT HAVE ARISING FROM ANY PERSONAL OR OTHER INJURY, INCLUDING MENTAL, EMOTIONAL OR PHYSICAL INJURY, LOSS OR DAMAGE TO PROPERTY, OR OTHER LOSS OR HARM OF ANY KIND, THAT THE CHILD MIGHT SUFFER OR INCUR IN CONNECTION WITH THE PROGRAM, INCLUDING LIABILITY FOR NEGLIGENCE (BUT NOT FROM LIABILITY ARISING FROM GROSS NEGLIGENCE OR INTENTIONAL WRONGFUL ACTS) ON THE PART OF THE FOJ’S OFFICERS, DIRECTORS, TRUSTEES, AGENTS, SERVANTS, ADMINISTRATORS, REPRESENTATIVES OR EMPLOYEES.

In addition, I hereby authorize FOJ and its employees and agents to use, without compensation, photographs or other likenesses of the Child for purposes related to FOJ’s business, including publicity, marketing and promotion of FOJ and any events or services it may offer. I acknowledge and agree that photographs or likenesses, and voice reproductions, of the Child may be copied and distributed by means of various media, including but not limited to the Internet. I waive any right to inspect or approve such media before distribution and relinquish and give to FOJ all rights, title and interest in any such media, including any copyrights therein. On behalf of the Releasers, I further release FOJ from any and all liability related to the dissemination of photographs, images, likenesses, voice reproductions and any recordings thereof.

This Waiver and Release of Liability shall be governed by and construed in accordance with the laws of the State of New York without reference to conflicts of laws rules, and this Waiver and Release of Liability Release shall be deemed executed and performed in the State of New York. The parties hereto also agree to submit to the sole jurisdiction of the courts of the State of New York for any and all actions relating to this Waiver and Release of Liability.

BY CHECKING THE BOX ON THIS PAGE, I AFFIRM THAT I HAVE READ AND UNDERSTOOD IT IN ITS ENTIRETY. I UNDERSTAND THAT I AM WAIVING IMPORTANT LEGAL RIGHTS.