KG – E 2

Acushnet Field Release Form

In consideration of participation in the South Coast Girls Softball League

offered by the South Coast Girls Softball, Inc.,  I, ______________________________________
                                                                                        (father/mother/guardian)

and/or ____________________________________ hereby assume all risk of personal
                                (participant)

injury or death or property damage from whatever causes during the conduct of the

program and I further will indemnify and save harmless the Town of Acushnet and

Acushnet School Committee, their officers, employees and agents from any and all

Liability or contribution for any liability arising from participation in the program.

 

Date: _________________ Name of participant: ______________________________

Father/Mother/Guardian: ___________________________

Witness: ________________________________________

I have health insurance (  ) Health Insurance Company: ________________________

Policy #: ________________________________________

I do not have health insurance (  )

Anyone without health insurance coverage is not allowed to participate.

Acushnet School Committee Policy Manual