Conshy U8 ID Clinic Registration
12/5/20 - 2:00-3:15 at The Proving Grounds Field #10

Registration and TEE’S GOLF CENTER, LLC, PLYMOUTH INDUSTRIAL CENTER, INC., AND THE PROVING GROUNDS LIABILITY RELEASE FORM

Must be filled out by a non-minor player or the parent or guardian of a minor player in order to attend.
Email address *
Player Last Name *
Player First Name *
Birth Year *
Date of Birth *
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Phone Number *
Emergency Contact: *
I (we), the undersigned parent(s)/guardian(s) of (please type child's full name): *
do hereby agree to release from any and all forms of liability whatsoever all persons associated with Tee’s Golf Center, LLC, Plymouth Industrial Center, Inc., and The Proving Grounds. I/We, hereby give my/our approval to participate in any and all league related activities. I/We know that participation in facility activities may result in serious injuries and protective equipment does not prevent all injuries. I/We acknowledge that I/We are aware of the COVID-19 virus and are aware of the risk and consequences of participating in facility activities which does not always provide for and afford the social distancing guidelines as mandated by the Centers for Disease Control, also referred to as the CDC, and other government agencies. I/We assume all risks and hazards including those associated with COVID-19 incidental to such participation including transportation to and from activities, and I/We hereby waive, release, absolve, indemnify and agree to hold harmless Tee’s Golf Center, LLC, Plymouth Industrial Center, Inc., and The Proving Grounds, the organizers, supervisors, participants and personnel transporting my/our child to and from activities, from any claim arising out of an injury to my/our child, whether the result of negligence or for any other cause, except to the extent and in the amount covered by accident or liability insurance.Also, I/We, the undersigned parent(s)/guardian(s), do hereby agree to indemnify and hold harmless any and all of the above mentioned individuals and/or groups and/or organizations from any and all losses suffered by virtue of any and all suit started or judgement obtained on behalf of my/our child arising out of any and all sickness/injury including infections and illness resulting from exposure to the COVID-19 virus sustained in regard to participation in the facility.Also, I/We, the undersigned parent(s)/guardian(s), do hereby agree to that Tee’s Golf Center, LLC, Plymouth Industrial Center, Inc., and The Proving Grounds or its coaches and assistants shall have the right in the event of any and all emergency, injury or illness, to send the child to the nearest hospital or physician available for treatment.Also, I/We, the undersigned parent(s)/guardian(s), do hereby acknowledge that I/We have, or will, purchase the medical/hospitalization insurance to cover my/our child in the event in which medical attention is necessary because of any accident/illness that is the result of/or related to the activities of the facility. Also, I/We, the undersigned parent(s)/guardian(s), do hereby agree to release the above-mentioned individuals and/or groups and/or organizations from any and all liability and/or injuries and/or illness including, but not limited to, infection resulting from exposure to the COVID-19 virus, and/or damages sustained from the sharing of personally owned equipment. This release and indemnity agreement is executed with full knowledge and understanding; and with the intention that I/We shall be legally bound therein. Please answer "YES." *
Please print your full name as your signature: *
Date: *
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