2019–2020 MWYTC Waiver/Release Form
Please provide a valid email address to receive a copy of the form when completed.

Questions or concerns? Reach Coach D by:
– Email: diane.cummins@olympian.org
– Call or text: 406-529-2013
Email address *
Begin Waiver / Release Form
PLEASE READ THIS FORM CAREFULLY and be aware that in signing up and participating in this program, you will be waiving and releasing all claims for injuries you might sustain out of this program.

As a participant in this youth track program, I recognize and acknowledge that there are certain risks of physical injury and I agree to assume the full risk of any injuries, damage or loss which I may sustain as a result of participating in any and all activities with or associated with this program.

I agree to waive and relinquish all claims I may have as a result of participating in this program against the Mountain West Youth Track Club, its officers or volunteers. I do hereby release and discharge the Mountain West Youth Track Club, its officers and volunteers from any and all claims from injuries, damage or loss which may accrue to me on account of my participation in this program.

I further agree to indemnify and hold harmless and defend the Mountain West Youth Track Club and its officers and it volunteers from any and all claims resulting from injuries, damages, and losses sustained by me and arising out of, connected with or in any way associated with the activities of the program.


“I have read and fully understand the above program details and waiver and release of all claims.”
Athlete's Full Name *
Your answer
Parent's Full Name *
Your answer
Today's Date *
MM
/
DD
/
YYYY
Witness *
Your answer
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service