Participant Permission Form printable pdf download

Parents—this is our general registration form that we use for most of our

youth town recreation programs including soccer, flag football,

volleyball, basketball, wrestling, instructional lacrosse, track and tennis.

Please print out this sheet. Complete the permission form

and cut into the half-size sheet. You may mail it, with

check if applicable, to: LCC, PO Box 98, LaFayette, NY

13084. You may also turn it directly in to the coach on

the first day of the program or drop at the town offices, in

a sealed envelope one week prior.

Baseball/softball (AVL), ULA lacrosse and Song Mtn skiing have different forms

that are available before the upcoming seasons each year.

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Town of LaFayette/LaFayette Community Council

Participant Permission Form

Name of player _______________________ Grade ____ Phone ____________

Mailing Address _____________________________________________________________

Email address for coach _____________________________________Shirt size ___________

Parents names (present at practices) ___________________________________

We strongly urge parents to stay at practice/games. Name a responsible adult in your absence.

Emergency contact if you are not present _______________________________

Medical conditions or concerns we should know: _________________________

I as parent/guardian of the above named child, hereby give my permission to participate in this LaFayette

Community Council program. I am aware that participation may result in serious injuries, and that protective

equipment does not prevent all injuries to players and do hereby waive, release, absolve, indemnify and agree to

hold harmless the Town of LaFayette, LaFayette Community Council, the organizers, sponsors, coaches, employees

and participants for any claim arising out of any injury to my child whether the result of negligence or for any other

cause, as a result of his/her participation in the program.

My child has permission to participate in

____________________

(please list sport)

Parent signature _________________________________________Date _______

Participant Permission Form