Stods Accident and Liability waiver form
Team/Coaches name and age level ________________Telephone___________
Name of Player: _______________age of player_______ Birthdate____________
Mailing Address: _____________________________________________________
City: ________________Zip: __________Email:____________________________
Accident insurance:
I waive and release Stods Baseball Inc and Eastside Baseball Association from all
liability from any injury or sickness while playing for Stods baseball teams and all
Stods Baseball programs/activities. I hereby give my permission for emergency
medical treatment in the event I cannot be reached. All participants must provide
proof of insurance coverage for any injury or sickness while playing for Stods baseball teams.
Release of liability: I authorize Stods Baseball Inc., Eastside Baseball Association
and it's employees to act for me in an emergency requiring medical attention.
I understand I am responsible for all hospital, laboratory, dental, and doctor's fees.
My child is physically fit to participate in vigorous physical activity.
I further understand that Stods Baseball Inc and its associates will not be held
responsible for accidents or illnesses. I hereby give my permission for my child
to participate on Stods Baseball teams, Eastside Baseball Association teams and all
Stods Baseball and Eastside Baseball Association programs/activities.
I represent that my child is physically able to participate and I further
acknowledge that there are certain risks of injury inherent in the participation
of any sport and that such an injury my occur. I hereby release and discharge
Bob Stoddard, Stods Baseball Inc., Eastside Baseball Association and any of its
employees from any and all liability, claims, demands, causes of action,
of any sort arising from any injury sustained by my child consequent of his
participation on Stods Baseball, Eastside Baseball Association teams
and all Stods Baseball and Eastside Baseball Association programs/activities.
By signing this form for registration I hereby acknowledge I have read the
above liabilities and accept the terms and conditions as outlined under
Accident insurance and Release of liability.
Parents Name (print)___________________Relationship to Player: _________________
Signature: _________________________________
Medical Insurance company: _________________ Policy Number: __________________
