Thursday Nights - $150/Team
2 Player Minimum - 4 Player Maximum
PV Town Park
May 18th - August 10th (No Cornhole on July 6th)
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Liability Emergency Medical Release:
I hereby give my permission to participate in the town sponsored Putnam Valley Parks & Recreation program. I certify that I am physically fit and that I will not hold PVPR or its agencies and/or representatives liable for any accidents and/or injuries incurred during the course of the program. I give my personal consent to be transported to any emergency facility if injury is sustained. I also consent to any treatment, surgery, diagnostic procedure or the administration of anesthesia that may be deemed necessary based on the medical judgment of the attending physician. PVPR will not tolerate abusive language or any type of misconduct at any of its functions.
Team Name *
Team Representative Name: *
Team Representative Email: *
Team Representative Phone #: *
Player #1 Name: *
Player #2 Name: *
Player #3 Name:
Player #4 Name:
I understand this informed Consent Form & agree to its conditions.  Team Representative Name & Date: *
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