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1C2D77B1-0CB2-4CF1-A024-39298DDD3DD8 (1)

RUSH
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Participant Waiver

Particpiant Release Waiver.pdf

Athlete's First Name*

Athlete's Last name*

Athlete's Birthday*

Month

Day

Year

Phone*

Email*

Address*

Check this box to confirm you are 18 or older

First and Last Name of Parent or Guardian (If under 18 years old)

Signature of Participant OR Parent/Guardian if under 18*

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Today's Date*

Month

Day

Year

Emergency Contact Name:*

Emergency Contact Phone:*

I have truthfully responded to the information requested above and have read and agree to the RUSH Athletics LLC Release, Waiver of Liability, Assumption of Risk & Indemnity Agreement.

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