Frederick Adult Co-Ed Softball League

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Frederick Adult Co-Ed Softball League FACSL Minor Waiver Form

PLAYER INFORMATION

* Team Name:

* First Name:

* Last Name:

* Street Address:

* City:

* State:

* Zip Code:

Phone:

* County of Residency:

* Birthdate:

* Gender:

* Are you on a Men's League roster in Frederick county?:

PARENT/GUARDIAN

* First Name:

* Last Name:

* Relationship to Minor:

* Email Address and/or Phone Number:

MEDICAL/EMERGENCY CONTACT INFORMATION

Emergency Contact:

Phone:

Relationship to Player:

WAIVER INFORMATION

In consideration of being permitted to participate in any sports activity on Frederick County-owned land, I, the signed parent/guardian, acknowledge, agree and understand that this minor:
1. Voluntarily and of my own free will, I elect to allow this minor to participate as a member of the team and organization indicated on this form.
2. There are certain risks and hazards involved in participating in any sport, including the one I have here elected to allow this minor to participate in, that may result in injury or death to this minor or other players, including, but not limited to, those hazards associated with weather conditions, playing conditions, equipment and other participants.
Further, I, the undersigned parent/guardian, agree that in consideration for the right for this minor to play as a member of the team designated, and in consideration for permission to play on the fields or courts arranged for by the team or organization throughout this year:
1. I voluntarily elect to accept and assume all risks of injury incurred or suffered by this minor (a) while practicing or playing as a member of the team so designated, (b) while serving in a non-playing capacity as a team member during practice or play by other players on their team, and (c) while on or upon the premises of any and all of the facilities arranged for by their team or organization for practice or play.
2. I release, discharge and hold harmless the team and organization designated on this form, the facility owner or other entity designated on this form, the Frederick County Parks and Recreation Division, Frederick County, its officers, agents, associations, employees, or any person or entity connected with the team, organization, or facility for any claim, damages, costs or cause of action which this minor has or may in the future have as a result of injuries or damages sustained or incurred by this minor from any cause related to their participation as a member of the team.
3. I agree and warrant that if at any time this minor or I believe conditions to be unsafe this minor will immediately discontinue further participation in the activity.

I/we agree with the above *

Please submit this form online and print a completed copy. Submit a parent/guardian signed copy to your coach. Thank you!

Signature:

Date:

* indicates required fields

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Frederick Adult Co-Ed Softball League FACSL Minor Waiver Form