KYYK Ball Youth Waiver

KYYK Ball Youth Waiver

KYYK 98.3 and Palestine CDJR Fiat KYYK Ball Youth Waiver and Release Form

Each player under 18 years of age MUST have a Waiver and Release Form completed and turned in in order to be eligible to play in the tournament.

 

Participant Name: _______________________________________

Date of Birth: __________________________________________

Physician: _____________________ Dentist: _____________________

Parent/Guardian Name:____________________________ Address: ______________________ City/State: _____________________ Zip: _________

Home Phone:(___)_____________ Work Phone:(___)______________ Cell Phone:(___)_________ Kickball Team Name: ________________________________________________________

 

PARENTS: KYYK 98.3 requires parents, or legal guardians, to assume the responsibility of providing accident/health insurance to cover your child while participating in this Tournament. It is understood that no claims for any injuries incurred as a result of participation in this Tournament will be made against KYYK 98.3 or any of its employees or volunteers.

 

The student listed above is covered by accident/health insurance from the following company:

Insurance Carrier: ______________________________

Address: _____________________________________

Name on Insurance Policy (Guarantor): _______________________________

 

 

I hereby give my permission for the above-named student to compete in the 2018 KYYK Ball Tournament. I have read and understand the rules for the tournament and hereby agree to abide by them. I realize that there is a risk of being injured that is inherent in all sports. I realize that the risk of injury might be severe, including the risk of fractures, brain injuries, paralysis or even death. Having been so warned, I hereby give my consent for my child to participate in the Tournament with full knowledge and understanding of the risk of serious injury that may result from inadvertent contact or hazards associated with weather conditions, playing conditions, equipment and other participants. I further grant permission to KYYK 98.3 personnel to provide immediate emergency care or secure ambulance services in case of illness or injury that may occur during the competition.

 

Parent’s Signature: _____________________________ Date: ________________________

 

STUDENTS: This application, to compete in the 2018 KYYK Ball Tournament, is made with the understanding that I have voluntarily and of my own free will, elected to participate as a member of a team. I have read and understand the rules for the tournament and hereby agree to abide by them. I realize that there is a risk of being injured that is inherent in all sports. I realize that the risk of injury might be severe, including the risk of fractures, brain injuries, paralysis or even death. Having been so warned, I hereby choose to participate in, with full knowledge and understanding of the risk of serious injury that may result from inadvertent contact or hazards associated with weather conditions, playing conditions, equipment and other participants to which I am exposing myself, the 2018 KYYK Ball Tournament.

 

Student’s Signature: _____________________________ Date: ________________________

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