Slip & Slide Kickball Waiver & Release of Liability

Winthrop Royalty Slip n’ Slide Kickball

Participant Waiver and Release of Liability

Participant Name: _____________________________________________________________

Date of Birth: _________________________________________________________________

Address: ____________________________________________________________________

Age: ________________________________________________________________________

Team Name: _________________________________________________________________

Parent/Guardian Name (if participant is under 18): ____________________________________________________________________________

Phone Number: _______________________________________________________________

Emergency Contact (if different from parent/guardian): ____________________________________________________________________________

Emergency Contact Phone Number: _______________________________________________

Acknowledgement of Risk

I understand that participation in the Winthrop Royalty Slip & Slide Kickball Tournament involves physical activity and may include risks such as slips, falls, collisions, sprains, strains, and other injuries.

I voluntarily choose to participate (or allow my child to participate) in this event and assume all risks associated with participation.

RELEASE OF LIABILITY

In consideration of participation in this event, I release and hold harmless the Winthrop Royalty Program, the Winthrop Chamber of Commerce, the City of Winthrop, event volunteers, sponsors, and organizers from any claims, demands, causes of action, damages, or liability arising from participation in the event, except in cases of gross negligence or willful misconduct.

MEDICAL TREATMENT

In the event of an emergency, I authorize event staff and emergency personnel to secure appropriate medical treatment for the participant if I cannot be reached immediately. I understand that participants are responsible for bringing water, staying hydrated, and notifying staff if they become ill or injured during the event.

MEDICAL INFORMATION

Does the participant have any allergies, medical conditions, or health concerns that event volunteers should be aware of? If so, please explain below.

____________________________________________________________________________

Does the participant carry any emergency medication (EpiPen, inhaler, diabetic supplies, ect.)? If so, please explain below.

____________________________________________________________________________

PHOTO RELEASE

I understand that photographs and videos may be taken during the event and may be used by the Winthrop Royalty Program, the Winthrop Chamber of Commerce and the City of Winthrop for promotional, social media, and informational purposes.

☐ I agree.
☐ I do not agree.

SIGNATURES

By signing below, I acknowledge that I have read and understand this waiver and agree to its terms.

Participant Signature (18 or older):

____________________________________________________________________________

Date: _______________________________________________________________________

Parent/Guardian Signature (required for participants under 18):

____________________________________________________________________________

Date: _______________________________________________________________________