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11th Annual Boston WIFFLE Ball Challenge

Thursday, June 2, 2022, from 5:30pm to 9:30pm

Permission and Waiver Form



Waiver, Trademark and Management: By signing this release form for participation in the Boston WIFFLE® Ball Challenge (hereinafter “Event”), Participant and/or their parent or guardian acknowledges the inherent risks involved with the physical activity of participating in the Event and agree to assume all such risk. Said Participant and/or their parent or guardian hereby releases Franciscan Children’s, Travis Roy Foundation, Inc., Blue Sky Sports & Entertainment, LLC, and any of their parents, affiliates, subsidiaries, directors, officers and employees (collectively referred to as “Event Organizers”), Boston University and its employees and agents, from any liability or claim for any accident, death, bodily injury or illness, personal injury and theft or loss of personal property that may occur during the Event or as a result of the Event.  It is also understood that Event Organizers, do not assume any responsibility for or obligation to provide financial assistance or other assistance, including but not limited to medical, health or disability insurance in the event of injury, illness, death or property damage. Participant acknowledges that all players must wear socks and sneakers. Footwear will be inspected, and those not wearing appropriate attire will not be allowed to participate.

 

Participant and/or their parent or guardian, acknowledges that Event Organizers may make sound recordings and take photographs or motion pictures during the Event (“Materials”), which may be used in television, radio, internet, and other forms of media for publicity, commercial, promotional and advertising purposes. Participant’s likeness may be used as described above without any compensation to Participant. Participant and/or their parent or guardian, hereby assigns the copyright of said Materials to Event Organizers and releases Event Organizers from any liability arising out of such use of Participant’s likeness as described above. 

                                                                                                                                                                                                                 

In the case of a medical emergency, Participant and/or Participant’s parent or guardian hereby authorizes the Event Organizers to act on their behalf to obtain emergency treatment for themselves or their son/daughter by any recognized hospital, doctor or emergency medical technician and hereby releases and forever discharges Event Organizers from any claims whatsoever which arise or may hereafter arise on account of any first aid treatment, emergency room treatment or other medical services rendered in connection with the Event and the activities at the Event.

 

By signing below, I state that I am the person or the parent/legal guardian of the minor child named below and confirm that I have read and understand the above statement regarding participation and release of liability in the Boston WIFFLE® Ball Challenge, and approve of its terms on behalf of myself or my child.

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Signature*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Signature*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Signature*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Signature*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Signature*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Signature*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Signature*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Signature*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Signature*
Parent or Guardian's (if participant in under the age of 18) Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Please Disclose Any Medical Conditions

Insurance

Insurance Carrier*

Insurance Policy Number*
Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's (if participant in under the age of 18) Name

First Name*

Middle Name

Last Name*

Relationship*

Phone*
Parent or Guardian's (if participant in under the age of 18) Date of Birth*
Parent or Guardian's (if participant in under the age of 18) Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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