Waiver And Medical Release Form - Texas Image Sand

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Waiver and Medical Release Form
I, ________________________________ agree to participate in the 2015/2016
Tournaments, Leagues, Open Play, Clinics and/or Other Events.
In
consideration of participation in any of these events, I agree, on behalf of the
above named individual, his/her heirs, and representatives to fully and forever
release, discharge, indemnify and hold harmless Winning Edge LP, Texas Image
LP, Texas Image Sand, and TIV LLC, it agents, servants and employees from
any and all claims, demands, damages, rights of action or causes, present or
future, whether the same be known, anticipated or unanticipated, resulting from
or arising out of participation in these events.
I HEREBY AUTHORIZE IN
ADVANCE ANY NECESSARY MEDICAL TREATMENT REQUIRED BY THE
ABOVE NAMED INDIVIDUAL WHILE IN ATTENDANCE OF THESE EVENTS. I
ACKNOWLEDGE THAT I HAVE/WILL NOTIFY THE CLUB PERSONNEL OF
ANY SPECIAL MEDICAL NEEDS OR INFORMATION REQUIRED BY THE
ABOVE NAMED INDIVIDUAL.
(State
Medical
Needs)
_________________________________________
___________________________________________________________
Also, I understand that all rules and regulations for the Leagues, Tournaments,
Camps, Clinics, Open Play and/or Other Events will be enforced and any
violation by the above individual will result in being asked to leave with no
refunds being given.
Signature
Date
Address
City
State
Zip
Phone #
Email Address

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