• PLAYER ENTRY FORM

  • INSURANCE: It is expressly understood that sponsors of Summer Jam '21 do not insure against, nor accept responsibility for, personal injury or property loss or damage to the participant which might be sustained as a result of his/her participation. Parents or legal guardian are responsible for medical care, treatment and insurance for said participant. RELEASE/WAIVER: In consideration of the above mentioned athlete to compete in SUMMER JAM '21 the undersigned, intending to be legally bound, release, and forever discharge any and all rights and claims for damages, including any claims for loss, damages or injury to athlete's person or property arising out of athlete's performance or failure of performance from Interfaith Community Services, Inc. (InterServ), St. Joseph Sports, Inc., Commerce Bank of St. Joseph, City of St. Joseph, and any other sponsors; their agents, representatives;successors and assigns. IF THE UNDERSIGNED HAS DOUBTS ABOUT THE PHYSICAL CONDITION OF SAID ATHLETE, A PRE-LEAGUE PHYSICAL BY EXAMINATIONALICENSED PHYSICIAN IS RECOMMENDED. In addition, the undersigned, hereby authorizes any first aid, medical treatment deemed necessary in case of emergency for said participant during competition and give permission for emergency treatment, X-rays or surgery as recommended by the attending physician. I/we (as parents or legal guardians) assume full financial responsibility for any and all medical care for participant. Entry fee is non-refundable. Any pictures or videotape of participant during competition may be used for promotional purposes of league activities. Any falsification of information thisformwill result in disqualification. InterServ will not discriminate on the basis of race, creed, age, national origin or handicapping condition. The undersigned, being the on parent(s) or the legal guardian(s) do hereby grant permission to Interfaith Community Services and its licensees, including but not limited to television, agency web page, newspaper, cablevision for any display photographs or film of my child for advertising and publicity purposes. The undersigned hereby waive any rights to inspect and/or approve the finished product or the use to which it may be applied.

  • Clear
  • USD

    loading smart payment buttons...
  • Should be Empty: