Waiver And Medical Release Form - Texas Image Sand

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Waiver and Medical Release Form
I, ________________________________ agree to participate in the 2016/2017
Practices, 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, its 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, Camps, Clinics,
and/or Other Events will be enforced and any violation by the above individual
will result in a call, to the parent or legal guardian, with a possible request to
come and pick up the above individual (older players, who drive, may be asked
to leave) with no refunds being given.
Signature of Parent or Legal Guardian
Date

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