Registration
One name per registration. Fill out the * information and sign the waiver by typing in your name and date. 
If you are a minor, then you need a parent to type in their name along with yours
Sign in to Google to save your progress. Learn more
First & Last Name *
Email Address *
Phone Number *
What skill level are you playing at now? *
What date do you want to start? *
How did you hear about PickleBall Outreach?

Please read and sign

PICKLEBALL PARTICIPATION LIABILITY WAIVER

Gary Heinlein, as an instructor, and PickleBall Outreach Network Ministries (PBO) offers pickleball lessons and pickleball activities for the general public. 

It is understood that the physical activities associated with pickleball are sometimes quite strenuous and can involve an element of risk and the associated danger of accidents. Participants in the lessons are aware of these risks and acknowledge accepting those risks.

In order to participate in any activities associated with these pickleball lessons, I agree to legally waive, release and discharge any claims for damages for personal injury, death or property which I may have, or which may occur to me as a result of participation in these pickleball activities or lessons. 

This release is intended to discharge in advance the individuals or entities named above from any and all liability arising out of or connected in any way with my participation with the pickleball lessons or associated activities even though that liability may arise out of negligence or carelessness on the part of the entities or parties named above. 

It is further agreed that this waiver, release and assumptions of risk is to be binding on my heirs, successors and assigns. Further, I agree to identify and hold the above persons or entities harmless from any loss, liability, danger that I may sustain while participating in any and/or all pickleball activities.

I also agree to receiving emails or text messages concerning changes in schedule or cancelations and update information. 

I do hereby give permission that pictures of me, involved in PickleBall Outreach activities, maybe used for promotional purposes.

*
Required
Type name as signature - Minors need a parent to type in their name along with yours.  *
Today's Date *
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report