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WCLBL Injury Release Form

PLAYER INFORMATION

PARENT/GUARDIAN #1

PARENT/GUARDIAN #2

MEDICAL/EMERGENCY CONTACT INFORMATION

I/We the parent[s]/guardian[s] of the above named player hereby give permission for the player to participate in West Cambridge Little Baseball League (WCLBL). I/We understand and agree that unless withdrawn by written notice to the President of WCLBL, this permission shall extend from year to year until such time as the player graduates from WCLBL or otherwise ceases participation in the program.

I/We the parent[s]/guardian[s] of the above named player understand and acknowledge that there is a risk of injury associated with playing baseball, and also risks associated with transportation to and form games and practices. I/We the parent[s]/guardian[s] of the above named player, agree to assume all such risks, whether they relate to playing baseball or transportation to and from the playing field, for as long as the player continues to participate in WCLBL.

I/We the parent[s]/guardian[s] of the above named player hereby agree to indemnify and hold harmless the WCLBL, their officers, board members, agents and representatives from and against any and all claims, liability, losses, costs, damages and expenses incurred or sustained by them, arising out of or in connection with the above named player's participation in WCLBL.

Consent to Medical Treatment of a Minor: I/We the parent[s]/guardian[s] give my/our consent to have the above named player treated by a physician or surgeon in case of a sudden illness or injury while participating with WCLBL. It is understood that WCLBL provides no medical insurance for such treatment and WCLBL takes no responsibility for the cost or quality of the medical treatment provided. Please note that the potential nature of such illnesses or injuries may require the use of emergency medical personnel.

West Cambridge Little Baseball League may post from time to time pictures of game action and players on the website www.wclbl.com. If you object to yours or your player or award's picture or image being photographed and/or displayed on the West Cambridge Little Baseball League website please check the decline box below.
Signature:
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