Pecan Valley Chapter 3 on 3 Tournament
Saturday, February 6, 2010

Please print clearly and complete all information.

TEAM NAME ______________________________________________

WAIVER AND RELEASE OF ALL CLAIMS AND ASSUMPTION OF RISK

Please read this form carefully and be aware that in signing up and participating in this program, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which you or your minor child/ward might sustain as a result of participating in any and all activities connected with and associated with this program (including transportation services and vehicle operations, when provided).
I recognize and acknowledge that there are certain risks of physical injury to participants in this program, and I voluntarily agree to assume the full risk of any and all injuries, damages or loss, regardless of severity, that I may sustain as a result of said participation. I further agree to waive and relinquish all claims I may have (or accrue to me) as a result of participating in this program against the Pecan Valley Red Cross, including its officials, agents,volunteers and employees.

PARTICIPATION WILL BE DENIED
If the signature of each participant and date are not on this waiver.

Player #1 Name__________________________________ Age______ BirthDate_____________________
Home Phone__________________________Email_______________________________________
Address_____________________________ City_________________________Zip_____________
I have read and fully understand the above waiver and release of all claims and assumption of risk.
PLEASE PRINT Participant’s Name ______________________________________________
Date __________ Participant’s Signature ______________________
(Must be 18 years or older)

Player #2 Name__________________________________ Age______ Birth Date_____________________
Home Phone__________________________Email_______________________________________
Address_____________________________ City_________________________Zip_____________
I have read and fully understand the above waiver and release of all claims and assumption of risk.
PLEASE PRINT Participant’s Name ______________________________________________
Date __________ Participant’s Signature ______________________
(Must be 18 years or older)

Player #3 Name__________________________________ Age______ Birth Date_____________________
Home Phone__________________________Email_______________________________________
Address_____________________________ City__________________________Zip_____________
I have read and fully understand the above waiver and release of all claims and assumption of risk.
PLEASE PRINT Participant’s Name _______________________________________________
Date __________ Participant’s Signature ______________________
(Must be 18 years or older)

Player #4 Name__________________________________ Age______ Birth Date_____________________
Home Phone__________________________Email________________________________________
Address_____________________________ City__________________________Zip_____________
I have read and fully understand the above waiver and release of all claims and assumption of risk.
PLEASE PRINT Participant’s Name _______________________________________________
Date __________ Participant’s Signature ______________________
(Must be 18 years or older)