Atlanta Wiffleball Association

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Register Here for Monday Night Wiffle @ Battery ATL!

* Summer@BatteryATL or Summer Fast Pitch:

PLAYER INFORMATION

* First Name:

* Last Name:

Street:

City:

State:

Zip Code:

* Phone:

Birthdate:

Email:

Gender:

* Shirt Size:

MEDICAL/EMERGENCY CONTACT INFORMATION

Emergency Contact:

Phone:

Relationship to Player:

WAIVER INFORMATION

ATLANTA WIFFLEBALL ASSOCIATION
2017 Individual Waiver and Release of Claims

This form is a release of claim form that encompasses all activities for 2017. By signing below, I am
acknowledging that I understand that my participation in any and all ATLANTA WIFFLEBALL ASSOCIATION (herein after, AWA) including leagues, tournaments, and athletic events includes a risk of injury.
For and in consideration for my participation in any 2017 AWA league, tournament, and event coordinated by 2017 AWA, I hereby, for myself, executors, successors and administrators assume any and all risks associated with my participation in the AWA, and release and waive any and all rights and claims that I may now, or in the future, have against AWA, its agents, employees, directors, officers and affiliates of the AWA, arising out of my participation in the AWA or any related activities. I hereby fully release and discharge AWA and its agents, employees, directors, officers and affiliates from any and all claims from injuries, damage or loss, including, but not limited to, any alleged negligence, which I may have or which may accrue to me from my participation in the AWA. I further agree to indemnify and hold harmless and defend AWA, its agents, employees, directors, officers, and affiliates from any and all claims resulting from injuries, damages and losses sustained by me and arising out of, connected with or in any way associated with the activities of the AWA. I acknowledge that AWA is not responsible for any inclement weather which may affect the AWA and release and waive all claims against AWA, its agents, employees, directors, officers and affiliates for damage or loss that may arise there from.

ATLANTA WIFFLEBALL ASSOCIATION does not provide accident insurance coverage for injuries received by participants.
Each participant should make sure that he/she has health insurance coverage. We cannot emphasize
this point enough.

By signing this waiver, I am acknowledging that I understand that participation in any sports and
events is voluntary and includes a degree of risk of injury.

PRINTED NAME: ____________________________________________________

SIGNATURE ______________________________________DATE: ____________

I agree with the above. By clicking, I am electronically signing this document. *

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IMPORTANT: Online Payment with credit cards is not active for this form

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