SCARBOROUGH OVER 55 COMPETITIVE SLO-PITCH LEAGUE

12 Leyton Ave, Scarborough, ON, M1L 3T4 – 416 694-9284 Tel & Fax    Cell 416 518-0542

                                   Softball Waiver

Please Print Clearly

NAME: ________________________________________________________________

 STREET: _______________________________________________________________

CITY: ________________________________   POSTAL:  ___________________

TEAM NAME: _________________________ HOME PH: __________________

Highest Level Played Last 2 Yrs: _______________ Cell Ph:  _____________________

E-MAIL: ________________________________________________________________

Shirt Size __________________    D.O.B. _____________________

2009 REGISTRATION FEE OF $45.00 (Cash or Cheque made payable to Duane Richards)

LIABILITY WAIVER

I, the undersigned, acknowledge that I am aware of the risk of injury inherent in the playing of Slo-Pitch Softball, and I am willing to accept that risk.

I hereby forever release, remise and discharge the Scarborough Over 55 Competitive Slo-Pitch League, its officers, managers, members, agents and servants of and from all actions, causes of actions, claims and demands arising from my membership in the League and / or my participation in its activities.

I understand and agree to adhere to all rules of play as set forth by the League and I am aware of the fact that I may be suspended from play without notice or recourse, financial or otherwise by the Umpire in Chief.

I hereby authorize the Scarborough Over 55 Competitive Slo-Pitch League, or anyone acting on their behalf, to seek and acquire any necessary medical aid, care or attention that may be required by the undersigned, as a result of any accident or injury that may be sustained by the undersigned player.

I have read and understand the foregoing and my signature is affixed voluntarily.

Dated: _________________ Signature: _________________________________________