Parental Waiver And Release Form printable pdf download

Parental Waiver And Release Form

PARENTAL WAIVER AND RELEASE FORM

As the parent or legal guardian of the child named below, I hereby give my full

consent and approval for my child to participate as a team member in the sport

designated below. I understand that there are certain risks of injury inherent in

the practice and play of this sport, as well as in traveling and other related

activities incidental to my child’s participation, and I am willing to assume these

risks on behalf of my child. I hereby certify that my child is fully capable of

participating in the designated sport and that my child is healthy and has no

physical or mental disabilities or infirmities that would restrict full participation in

these activities, except as listed below.

In addition to giving my full consent for my child’s participation, I do hereby

waive, release and hold harmless the organization named below, its officers,

coaches, sponsors, supervisors and representatives for any injury that may be

suffered by my child in the normal course of participation in the designated sport

and the activities incidental thereto, whether the result of negligence or any other

cause.

________________________________________________________________

__________________________

______________

_____________

Name of Child

Date of Birth

Sex

____________________________________________________

Street Address

__________________________

____________________

City

State

Please list any physical limitations (allergies, hearing, sight, etc.)

Designated Sport

Swimming / Diving / Both (circle one)

__________________________

______________

Parent’s Signature

Date

Northern Kentucky Swim League, Inc.

Name of Sponsoring Organizations

Parental Waiver And Release Form