Waterford Parks and Recreation Department
5200 Civic Center Drive, Waterford, Michigan 48329
Phone (248) 674-5441 Fax (248) 618-7674
2021 SUMMER BALL
WAIVER OF LIABILITY – PLAY UP
(1 year of play-up starting at age 4 allowed – maximum)
I, give my permission for my son/daughter
Parent’s Name
to move up from the ________________age group to
Child’s Name
the ________________ age group. I realize that my child is not old enough to participate in the
____________________ age group and I accept full responsibility for this move.
-OR FOR CHILDREN WHO ARE 4 YEARS OF AGE (ONLY ELIGIBLE FOR BOY PLAYERS
TURNING 5 AFTER 8/31/21 and GIRL PLAYERS TURNING 5 AFTER 1/1/21).
I, give my permission for my son/daughter,
Parent’s Name
to move up to the 5-6 year age group. I realize that my child
Child’s Name
is not old enough to participate in the 5-6 year age group and I accept full responsibility for this
move.
In consideration for the foregoing, I for myself, my Executors, Administrators, and Assignees, do
hereby release and discharge all Sponsors, Waterford Parks and Recreation Department, its
employees and any individuals associated with the Summer Ball Program, for all claim or
damages, demands, actions and whatsoever a in manner arising or growing out of my
participation in said sport.
I hereby assume all responsibility for my child, and waive all claims for liability against the
Waterford Parks and Recreation Department, the Waterford School District, Coaches, Umpires,
or any other representatives connected in this league.
In the event of injury I give my permission and consent to authorize “First Aid and or Medical
Treatment” as deemed necessary.
Parent’s Signature
Date
click to sign
signature
click to edit
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