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15U Tryout Registration Form

PLAYER INFORMATION

PARENT/GUARDIAN #1

PARENT/GUARDIAN #2

MEDICAL/EMERGENCY CONTACT INFORMATION


Players are asked to attend ALL of the following tryout dates that they are available:

Sunday, October 1 from 4:00 - 6:00 at Vernon Young Memorial Park
Sunday, October 8 from 4:00 - 6:00 at Vernon Young Memorial Park

Vernon Young Memorial Park is located at 124 Ardmore Ave., Ardmore, PA


Additional Comments or Questions:
WAIVER INFORMATION
Media Release
I authorize Revolution Baseball to reproduce and/or publish pictures, video, or any likeness of my child and give permission for their name to be used for any news or promotional purposes by Revolution Baseball.

Medical Treatment Authorization
I authorize the Revolution Baseball coaches, staff or designated representatives to obtain emergency medical treatment for the above named participant in the case that I am unable to do so myself.

Tryout Waiver
Please read this form carefully and be aware that in registering yourself or minor child/ward for participation in the tryout, you will be waiving and releasing all claims for injuries your child/ward might sustain arising out of the tryout, facility use program/programs/camp. When signing below you certify that the information on this form is true and correct and you, as the parent/guardian of the above named minor, consent that your son is permitted to participate in this tryout.

Waiver:
I recognize and acknowledge that there are certain risks of physical injury to participants in the above program and I agree to assume the full risk of any such injuries, damages or loss regardless of severity which myself or my child/ward may sustain as a result of participating in any activities connected or associated with any such program(s). I waive and relinquish all claims I or my child/ward may have against Revolution Baseball and its coaches, officers, agents, servants, volunteers and employees as a result of participating in any of the program(s). I hereby fully release and discharge Revolution Baseball and its coaches, officers, agents, servants, volunteers and employees from any and all claims from injuries, damage or loss which myself or my child/ward may have or which may accrue to me or my child/ward on account of the participation of my own or my child/ward in any programs(s). I further agree to indemnify and hold harmless and defend Revolution Baseball and its coaches, officers, agents, servants, volunteers and employees from any and all claims resulting from injuries, damages and losses sustained by myself or my child/ward, and arising out of, connected with, or in an way associated with the activities of any of the program(s).

I HAVE READ AND FULLY UNDERSTAND RISK AND WAIVER AND RELEASE OF ALL CLAIMS. IF REGISTERING ON-LINE OR VIA FAX, MY ON-LINE OR FACSIMILIE SIGNATURE SHALL SUBSTITUTE
 

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