Home | Participating Teams | Tournament Registration | Waiver Form | Team Roster |Directions | Lodging | Brackets

Ultimate Sports Promotions, LLC

AGREEMENT, RELEASE ANDWAIVER OF LIABILITY FORM

FOR TOURNAMENT PARTICIPATION

Full Team Name: _____________________________ Age: _______________

Insurance Carrier: _____________________________ Policy #: ________________

I/We the undersigned fully understand that athletic and recreation programs and activities involve some form of risk or accident and may result in serious injuries and that protective equipment does not prevent all injuries to players and participants. I/We hereby waive, release, absolve, indemnify, forever discharge and agree to hold harmless, Ultimate Sports Promotions, City Leisure Services Department, Tournament Sanctioning Body, and any of its authorized agent(s) or heir(s) harmless from liability, claims, demands, and judgments arising at any time when I/We and my child participate in any program activity.

I/We authorize the any of the above mentioned parties in bold to act in my behalf to authorize medical treatment to, upon, or for the benefit of myself and/or my child, for any injuries which may occur form participation in any athletic/recreation program/activity. In the event of an injury that may require emergency treatment, I/We authorize such personnel to see that myself and/or my child is transported to and treated at the nearest medical facility. I/We recognize that any such treatment(s) shall be my full financial responsibility.

PLAYER’S LEGAL NAME (TYPE OR PRINT) PARENT/GUARDIAN SIGNATURE

1. _______________________________________ ____________________________________

2. _______________________________________ ____________________________________

3. _______________________________________ ____________________________________

4. _______________________________________ ____________________________________

5. _______________________________________ ____________________________________

6. _______________________________________ ____________________________________

7. _______________________________________ ____________________________________

8. _______________________________________ ____________________________________

9. _______________________________________ ____________________________________

10. _______________________________________ ____________________________________

11. _______________________________________ ____________________________________

12. _______________________________________ ____________________________________

13. _______________________________________ ____________________________________

14. _______________________________________ ____________________________________

15. _______________________________________ ____________________________________

16. _______________________________________ ____________________________________

As manager of the above named team, I do hereby certify that the information, names, and signatures above are true and accurate to the best of my knowledge.

____________________________________ _____________________________

Manager’s signature Date