Author: sports

Team Name League
Manager Daytime Phone
Address Evening Phone
Email Address
Asst. Manager Daytime Phone
Address Evening Phone
Email Address
I give permission for my child/myself (18+) to participate in the Willard Parks and Recreation Fall Adult Basketball League and agree to hold the City of Willard, any of its employees, and the City of Willard Park Board harmless for any injury or damage to myself/child as a result of his/her participation. I agree to abide by the Code of Ethics. I also understand that their name or photo may be used for media purposes. By signing below I agree to the stipulations on the form.

WILLARD PARKS AND RECREATION Ultimate Frisbee
Summer 2016

Player Name / (print or type)	Player Signature	Player Address	Phone / Number

OFFICE USE ONLY Receipt#: ______________ Check#:________ Date: ____________ Circle: Cash CC Payment: $200