INDEPENDENT CHURCH LEAGUE

   Team Roster, Waiver and Minor Release Form

SOFTBALL 2012 - I consent to my participation in the activity or program of the Independent Church League (ICL) and I am fully aware of the risk inherent in this activity, including physical injury, damage to my property, or other consequences that may arise or result directly or indirectly from the activity. Being fully informed as to these risks and in consideration of the privilege of participating in the above-described activity, I assume all risk of injury, damage and liability. I agree to defend, indemnify and hold harmless the Independent Church League and its board members, the City of Lacey, Lacey Parks & Recreation, United States Specialty Sports Association (USSSA) and the Olympia Specialty Sports Umpire Association (OSSUA) from any claim or lawsuit for injury, illness, damage or others loss incurred during the period covered by this activity. (No new players added after ________)

VOLLEYBALL 2012-2013 - I am fully aware of the risk inherent in this activity, including physical injury, damage to my property, or other consequences that may arise or result directly or indirectly from the activity. Being fully informed as to these risks and in consideration of the privilege of participating in the above-described activity, I assume all risk of injury, damage and liability. I agree to defend, indemnify and hold harmless the Independent Church League and its board members, Olympia Christian School, Good Shepherd Lutheran, South Sound Community Church and Faith Community Center from any claim or lawsuit for injury, illness, damage or others loss incurred during the period covered by this activity. (No new players added after __________)

DODGEBALL 2012  - I am fully aware of the risk inherent in this activity, including physical injury, damage to my property, or other consequences that may arise or result directly or indirectly from the activity. Being fully informed as to these risks and in consideration of the privilege of participating in the above-described activity, I assume all risk of injury, damage and liability. I agree to defend, indemnify and hold harmless the Independent Church League and its board members, Faith Community Center from any claim or lawsuit for injury, illness, damage or others loss incurred during the period covered by this activity. (No new players added after ________)

 TEAM   COACH NAME   SPORT    LEAGUE                    

 Print or Type Name

Last  -  First  -  Middle Int

 

Player Signature

 

M/F

Age

13-17

Age 

18-99

If Player is under 18,

Print Parents Full Name / Parent Signature 

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Submitted By (Name):       Today's Date 

Comments:    

 

1) Coaches must have a completed WSP Background Check on file with the League if players or coach on the team is under 18 (Waiver) is required.

2) Before submitting the roster, review your information for accuracy, then click on the Print hyperlink below and print 2 copies of your form.

3) 1 copy will be retained for your record and the 2nd copy will be turned in to the League Secretary with all required signatures when requested.

4) Next click on the submit button below to send your roster to the Web Manager. Additional players can be added in this manner till the cut-off date.  

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