Youth Sports Release of Liability

Student's Name:

Student's Date of Birth: *

Student's Grade:

Please list any medical conditons that could impact your student's health (such as asthma or a heart problem):

Parent:

Address:

Email:

Phone:

Emergency Contact:

Emergency Contact Number:

I hereby consent to allow my son or daughter to participate in YOUR COMPANY NAME HERE Sports Program. I consent to not hold YOUR COMPANY NAME HERE or any of their officers / program volunteers responsible for any injury to my son or daughter. I agree not not pursue any legal action against any employee or volunteer of YOUR COMPANY NAME HERE.

Parent Signature:

Date:

Privacy & Cookies

This site uses cookies. By continuing to use this website, you agree to their use. To find out more, including how to control cookies, see here Cookie Policy

Accept Decline