Fillable Printable Athletic Waiver Form - Western Wyoming Community College

Athletic Waiver Form - Western Wyoming Community College

WWCC Athletic Try-out

Release & Waiver Form

Personal Information:

Insurance Information:

Release and Liability Waiver:

*Parent/guardian MUST sign this form if the athlete is under the age of 18.*

Name

Address

CityStateZip Code

Age

Grade

Cell Phone

Insurance Company

Policy #

Group #

In case of emergency, please notify

Phone Number

In recognition of, and with knowledge of, the fact that engaging in the sport/activity of

could involve substantial risk of personal injury, I, the undersigned, warrant that I am in good physical

condition and hereby agree to assume the risk of any injury I may suffer as a result of my participate in

try-outs at Western Wyoming Community College (WWCC) to be held on

Therefore, in consideration for being permitted to participate in such try-outs, I hereby release,

waive, and forever discharge Western Wyoming Community College, the Athletic Department, the

Coaches and the WWCC trainers from any and every claim, demand or actions of whatever kind,

arising from any bodily harm, personal injury or death resulting from any accident which may occur as

a result of participation in these try-outs. Further, and to the same extent and scope, I release said

parties from any claim whatsoever which may be attributable to the receipt of first aid or other

emergency treatment rendered me in connection with my participation in such try-outs. I understand

that WWCC will not provide any assistance with any medical bill(s) associated with my try-out or

participation with a WWCC team should I be injured.

I, the undersigned, affirmatively swear that I am, at the time of signing, of legal age and fully

competent to and do hereby execute this Release and Waiver on behalf of myself, my heirs, or assigns.

I further represent and warrant that I have read and fully understand the terms of this document and

their legal significance.

In witness whereof I have voluntarily and without inducement from any party, executed this Release

and Waiver on

Name (Printed)

Witness (Printed)

SignatureWitness Signature

Parent's Signature

Date