CITY OF CHANDLER - RECREATION DIVISION
OFFICIAL WAIVER & RELEASE OF LIABILITY & INDEMNIFICATION FORM
ADULT SPORTS TEAM ROSTER
I, the undersigned player or parent or legal guardian of a minor player named below, acknowledge, agree and understand that: 1.) Voluntarily and of my own free will, I elect to participate as a member of an adult sports team
and league indicated below. 2.) I understand that there are certain risks and hazards involved in participating in adult sports including, but not limited to those hazards associated with weather conditions, playing conditions,
equipment and other participants in addition to the acts of pitching, throwing, elding, hitting, shooting and catching of the ball, the swinging of the bat, running, jumping, stretching, sliding, diving, and other collisions with
other players and with stationary objects, all of which can cause serious injury or death to me and to other players. Further, I agree that in consideration for the right to play as a member of the team designated below and in
consideration for permission to play on the eld arranged for by the team or league: 1) I voluntarily elect or accept and solely assume all risk of damages, injury, including death, incurred or suered by me (a) while practicing
or playing as a member of the team so designated, (b) while serving in a non-playing capacity as a team member or observer during practice or play by other teams or by other players on my team, and (c) while on or upon
the premise of any and all of the elds/courts arranged for by my team or league for practice or play. 2) I release, discharge, and agree not to sue the team and/or league designated below or any owner or lessee of elds/
courts on which adult sports is played or practiced by my team or their owners, ocers, agents, servants, associations, employees, or any person or entity connected with the team, league, eld/court for any claim, damages,
costs, or cause of action which I have or may in the future have as a result of injuries or damages sustained or incurred by me from whatever cause including but not limited to the negligence, breach of contract, or wrongful
conduct of the parties hereby released. I further agree that I shall hold harmless and fully indemnify the parties hereby released from any claims, damages, costs including attorney fees, and cause of action which may arise
from any claim or cause of action made by me, through me or on my behalf even if the damages, injuries or death are caused in whole or in part by any of the parties or entities hereby released. I ACKNOWLEDGE THAT I HAVE
READ AND THAT I UNDERSTAND EACH AND EVERY ONE OF THE ABOVE PROVISIONS IN THIS WAIVER, RELEASE OF LIABILITY AND INDEMNIFICATION AGREEMENT AND AGREE TO ABIDE BY THEM.
PRINT PLAYER’S NAME HOME/CELL PHONE
WORK/HOME ADDRESS
(Street, City, State, Zip)
SIGNATURE*
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*Signatures are not required during registration. They will be collected before the rst game.
TEAM MANAGER’S AFFIDAVIT
I am the manager of the above mentioned team and, after being rst duly
sworn, depose and say that all of the information supplied above is correct
to the best of my knowledge and that all of the players signed the above in
their handwriting and they are eligible to compete with my team in the City
of Chandler league play. I have read and agree to all the rules of the City of
Chandler Adult Sports program and verify to the best of my knowledge that all
information given is accurate and true. I also understand all participants play
at their own risk and are responsible for their own health insurance.
Team Name: ____________________________ Team Color: __________________________
Former Team Name: ____________________________________________________________
Manager’s Name: _______________________________________________________________
Manager’s Address: ____________________________________________________________
City: ______________________________ State: ____________ Zip: _______________________
Home Phone: _____________________ Work/Cell Phone: __________________________
Manager’s Email: _______________________________________________________________
Manager’s Signature: ___________________________________________________________
PLEASE MARK AND LABEL YOUR 1ST, 2ND, AND 3RD CHOICE
SOFTBALL
at Snedigar Sportsplex
MEN’S
(Double-header)
[ ] Tue. – D1
[ ] Tue. – D2
[ ] Wed. – C1
[ ] Wed. – C2
[ ] Thur. – D1
[ ] Thur. – D2
CO-REC
(Single-header)
[ ] Fri. – D1
[ ] Fri. – D2
CO-REC
(Double-header)
[ ] Mon. – D1
[ ] Mon. – D2
[ ] Fri. – D
SOFTBALL
at Folley
MEN’S
(Double-header)
[ ] Thurs. – D2
CO-REC
(Single-header)
[ ] Fri. – D1
[ ] Fri. – D2
CO-REC
(Double-header)
[ ] Sun. – D
MEN’S BASKETBALL
[ ] Sun. – B1 Very Competitive (Hamilton)
[ ] Sun. – B2 Competitive (Hamilton)
[ ] Sun. – C Intermediate (Hamilton)
[ ] Sun. – D Recreational (Hamilton)
[ ] Sun. – D Recreational (Tumbleweed)
[ ] Thurs. – D 35+ (Tumbleweed)
CO-REC VOLLEYBALL
[ ] B – Competitive
[ ] C – Recreational
KICKBALL
[ ] D – Recreational
FLAG FOOTBALL
[ ] Sat. – Intermediate (AM)
SEASON/YEAR
[ ] Winter _________
[ ] Spring __________
[ ] Summer _______
[ ] Fall _____________
click to sign
signature
click to edit
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