ADULT LEAGUE FREE AGENT FORM

Your Name: * First Last
Division: *
C. Semi-Competitive D. Recreational
Phone * - ### - ### ####
Email *
I understand/agree: *
By submitting this form, I hereby authorize the staff of Hardwood Palace to act for me according to their best judgement in any emergency requiring medical attention, and I hereby waive and release Hardwood Palace from any and all liability for any injuries incurred while on the facility property. I have no knowledge of any physical impairment that would be affected by my participation in the Hardwood Palace program. I also understand that Hardwood Palace retains the right to use for publicity and/or advertising purposes any photographs of any participants taken at Hardwood Palace events.