siege
Siege Soccer Tournament Waiver of Liability / Release Form
BOYS / GIRLS
Team Name:
Age/Division:
Coach's Name:
Emergency #:
Manager Name:
Emergency #:
Additional #:
Permit to Host Form:
This form is REQUIRED at time of check in - COMPLETED.
Print Clearly
TOURNAMENT USE ONLY
Uniform
Regular/
Medical
Birth
Player Name
Parent Signature
Date of Birth
Number
Guest
Roster(s)
Player Card
Pictrue
Release
Certificate
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In consideration of the furtherance of your purposed, objectives and aims, in consideration of your permitting me to participate in your tournament,
of behalf of myself, my heirs, executors, administrators and assigns. I hereby waive and release all rights and claims for dameages, which
I may have against you. The Siege at St. Francis Tournament, St. Francis Soccer Club, St. Francis Hospital, as well as any other person,
sponsors, organization or corportation who is sponsoring or assisting in the tournament.
This Team was checked in by: