PARTICIPANT RELEASE OF LIABILITY - READ BEFORE SIGNING
All leagues require that each club engaging in sanctioned play, provide insurance coverage for each of their
participants. Each P.A. players name, therefore, is included in our Group Insurance Plan. (beginning at age six)
In the event that an injury is suffered by one of our athletes, parents and/or guardians are expected to use
their primary personal insurance coverage first, league insurance second, with Penn Academy insurance as
a third coverage.
I, being the parent/guardian of the child/children named above, do hereby approve of the participation of
my children/wards in the activities of Penn Academy A.A. Furthermore, I do hereby release P.A.A.A., along
with their successors and assigns, any and all coaches, agents and officers; from any liabilities for personal
injury or property damage resulting or incurred during sponsored activities. (This includes transportation
to and from games)
In addition to the above, I do agree to maintain and return promptly, all uniforms and equipment to P.A.A.A.
at the requested date and location, and to pay for any lost or damaged equipment assigned to an individual
under my custodial care. I understand that failure to comply with these regulations will result in my child
not being permitted to register for additional sports.
In consideration of being allowed to participate in any way in the Penn-Crisp Inc. Gymnasium, I, the
undersigned, acknowledge, appreciate, and agree that:
1. The risk of injury from the activities involved in this program is significant, including the potential for
permanent paralysis and death and while particular rules, equipment, and personal discipline may
reduce this risk, the risk of serious injury does exist; and,
2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM
THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and
3. I willingly agree to comply with the stated and customary terms and conditions for participation, If
however I observe any unusually .significant hazard during my presence or participation, I will remove
myself from participation and bring such to the attention of-the nearest official immediately; and
4. I, for myself and on behalf of my heirs, assigns, personal representative and next of kin, HEREBY
RELEASE, INDEMNIFY, AND HOLD HARMLESS The Penn-Crisp Gymnasium, their officers, officials, agents
and/or employees, other participants, sponsoring agencies, sponsors, advertisers,' and, if applicable,
owners and lessors of premises used to conduct the event ("Releasees"), WITH RESPECT TO ANY AND
ALL INJURY, DISABILITY, DEATH, or loss damage to person or property, WHETHER ARISING FROM THE
NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
FOR PARENTS/GUARDIANS OF THE PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT TIME OF REGISTRATION)
This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree
to his/her release as provided above all the Releasees, and, for myself, my heirs assigns, and next to kin, I
release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my
minor child's involvement or participation in these programs-as provided above, EVEN IF ARISING FROM
THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.
I have read, understand, and agree to comply with, the membership guidelines stated above:
___________________________________________________ DATE:______________________________
x
PARENT/GUARDIAN'S SIGNATURE EMERGENCY PHONE # (s)
TO ALL PARENTS:
It will be REQUIRED that an adult member of each family registered for each season invest a few hours
service in our snack bar twice during the playing season. You will be notified as to which days you have
been scheduled to work. Indicate below which two dates you would prefer to donate your time.
We are also in need of coaches, if you are interested in coaching a team, please indicate which team(s) below: