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Women's Summer SOCCER LEAGUE
Updated 3/10/2005
HOLD-HARMLESS FORM
Each player participating in the Women's Summer Soccer League
must have the following form signed by both parents/guardians. Team officials should make enough copies for the
team members and forward the signed copies to Doug Hunt by June
11.
Players CANNOT participate without this signed statement.
I/WE hereby give my/our permission for the participation of my/our child in the athletic program of the Women's Summer Soccer League. I/We understand that care and caution will be exercised by the Women's Summer Soccer League, its coaches, players, representatives and referees involved in this activity. I/We also understand that participation in athletic competition carries a risk of injury. I/WE agree to Hold-Harmless the Women's Summer Soccer League, its' coaches, players, representatives and playing field owners involved in this activity. I/We furthermore certify that my/our knowledge based on medical examinations that the participant suffers from no pre-existing medical condition, which would be aggravated or injurious to the participant in this activity.
Click on Box and type information. When complete, click print button
at the bottom of the page. NO
INFORMATION IS PASSED THROUGH THE INTERNET.
Sign and mail form.
Name of Participant: Insurance Company: Policy Number: Signature of Father/Male Guardian: ___________________________________________________ Signature of Mother/Female Guardian: _________________________________________________ Participants Signature: ______________________________________________ Date: ___________________________
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