PUL Responsible Adult Form
The purpose of this form is for a parent/legal guardian to acknowledge the supervision of a Junior-aged player by a Responsible Adult, and the acknowledgment of the same Responsible Adult to accept this responsibility, for the Junior aged player to participate in a PUL league or event that is of an adult content. There is no PUL appointed supervision for adult leagues or events and there are no referees or convenors on site. Any Junior player who participates in PUL leagues or events, as well as their parent/legal guardian, must acknowledge this fact and waive PUL from responsibility associated with PUL leagues or events. It is the duty of the parent/legal guardian to ensure that if their Junior player is participating in PUL adult leagues or events, that they are under the supervision of a Responsible Adult as defined below:
Email address *
Definition of a Responsible Adult
A Responsible Adult is a person aged 25 years of age or older, endorsed by the Junior participant’s legal guardian, who supervises the Junior participant. It is their duty to ensure that the Junior participant is safe and protected from any environment that is physically or emotionally inappropriate. This responsibility includes full supervision of the Junior throughout the course of his/her participation in the PUL league/event, and possibly removing the Junior from any inappropriate situation.

A Responsible Adult is declared to the league convenor via the PUL Responsible Adult Permission Form, signed by the parent or legal guardian, at registration for the league/event. The Junior and Responsible Adult should be declared to the opposing captain prior to the start of each game.

Responsible Adult Name *
Your answer
Contact Information- Phone: *
Your answer
Contact Information- Email: *
Your answer
Junior Player Name (1): *
Your answer
Date of Birth: *
MM
/
DD
/
YYYY
Parent/Guardian Name: *
Your answer
Parent/Guardian Contact Information: *
Your answer
League that the Junior will be participating: *
Required
List Team Name(s): *
Your answer
List Team Captain(s): *
Your answer
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