Sport Tournament Dates: 7/11/2018, 7/20/2018, 7/25/2018, 8/8/2018
Event Address: See flyer
Contact us at (708) 656-1400 or email ivargasjr@corazoncs.org
Email address *
Name *
Address *
Phone Number *
If you are under the age of 18, we will need your parent to call in to verify that you have permission to participate in the sport tournaments. *
What Tournament Will You Do? (select date(s) and age bracket) *
I agree that I am voluntarily participating in a series of recreational community events hosted by the Corazón Community Service. Participating in these events involves various levels of physical activity. I acknowledge that participating in any recreational events or any other physical activity while attending this event can be potentially hazardous and may lead to injury, especially if not done correctly. I assume all risks associated with exercising (physical activity such as walking, jogging, running, etc.) but not limited to: falls, contact with other participants, the effects of weather, including high heat and/or humidity. Having read this waiver and knowing these conditions. I waive any claims I may have for damages/injuries whether seen or unseen, including negligence, injury or death, against Corazón Community Services, Corazón Community Services Staff and Board Members, Cicero Park District (Clyde Park), The Town of Cicero, District 99 & 201 Schools, volunteers, other participants, partnering agencies, affiliates or sponsors. By signing this document I authorize Corazón Community Services to use my name and photographs, video, or any other recording during the participation of any Peace Movement 2018 events. I have read and comprehend the risks that are involved with my voluntary participation in this program. I have been advised to submit, at my own expense and time, to a medical examination to ensure myself, and assume my own responsibility of physical fitness and capability to perform under the normal conditions. To the best of my knowledge I am in good physical fitness and comprehend that I am potentially placing my body in harm by participating in physical activities during this event. By checking off the following I agree to all the regulations mentioned above. *
A copy of your responses will be emailed to the address you provided.
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