Author: Jessica Hammett

Coed Kickball League

Phenix City Parks and Recreation Presents

Team Name: _________________________________
Coaches Name: ______________________________
Coaches Number: ____________________________
Coaches email: _______________________________

When: Monday Nights in June
Where: Southside Softball Complex
Fee: $25 per team

Waiver of Liability Release Form
I, kickball participant, acknowledge, agree and understand that voluntarily and of my own free will, I elect to participate as a member of the above team. I understand that there are certain risks and hazards involved in participating in this sport that may result in injury or death to me or other players I voluntarily elect to accept and assume all risks of injury incurred or suffered by me while practicing or playing as a member during practice or play by other teams or by other players on my team, and while on or upon property of the City of Phenix City, Parks & Recreation. I will not hold the City of Phenix City, Parks and Recreation or any of its staff liable, and release them from liability for losses of any personal property and injuries or accidents suffered during my participation in this activity. I acknowledge that I have read and that I understand the above waiver, release of liability and agree to abide by it.

Register by May 29th at Parks and Rec Main Office.
For further information contact Jessie Hammett @ 334.291.4719 and check out our website @ quickscores.com/phenixcity

Print Name	Telephone #	Signature

No Age Limit!!