Waiver Form

page-template,page-template-full_width,page-template-full_width-php,page,page-id-590,bridge-core-1.0.5,wp-featherlight-captions,ajax_fade,page_not_loaded,,qode_grid_1300,footer_responsive_adv,hide_top_bar_on_mobile_header,qode_header_in_grid,wpb-js-composer js-comp-ver-6.10.0,vc_responsive

Waiver Form

Liability Waiver Form

Please read, understand & sign this waiver/concussion form prior to participate FYBC sport activity. For more concussion information please visit www.cdc.gov/concussioninyouthsports

Player Name*
First Last
Gender*
Date of Birth*
MM slash DD slash YYYY
Parent/Guardian's Name*
Phone Number*
Address*
Street Address Address Line 2 City State ZIP Code
Emergency Secondary Contact*
Consent*
I agree
I/We, the parents/guardians of the named players above have read and fully understand the meaning and consequences of the wavier and thus voluntarily execute this waiver accordingly. We hereby agree that FYBC Board of Directors, staffs, tournament officials, coaches, volunteers, gym sites and all affiliated parents shall not hold or be liable for any illness, or injury sustained as result of participating in the FYBC Sport Activities. By signing this agreement, we waive all rights and claims for such injury and loss. Furthermore, we authorize FYBC officials, agents and officers to obtain medical treatment and services for any injured player whose parents/guardians are not present at the time of the injury, and agree to pay the fees and costs of such medical treatment and services. Finally, we agree to be responsible for any damages caused by the named players to the facilities and premises at this event.

Waiver Form

Liability Waiver Form

About Us

Search