CITY OF SANTA MONICA
Adult Sports
Leagues
Name
of Team: ______________________________________ Date: _________________
Name
of Manager: _____________________________ Home Phone: _________________
Manager’s
Address: ____________________________ Business Phone: ______________
Email
Address:
__________________________________________________________
In Consideration of the below applicant’s participation in the above activity’s, I hereby waive, release and discharge all claims for damages for death, personal injury, or property damage which I may have or which may hereafter accrue to me as a result of engaging in said activity or any activity incident thereto. This release discharges in advance the City of Santa Monica, it’s officers, agents, servants and employees from liability even though that liability may arise out of negligence or carelessness on the part of the persons or entitled mentioned above. Some recreational activities involve an element of risk or danger of accidents, and knowing those risks, I hereby assume those risks. This wavier, release and assumption of risk is to be binding on my heirs and assigns. I also give my permission for any necessary medical care.
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Print
Name & Signature |
Home Address, City and Zip |
Is
Your Work or Business in Santa Monica ?
Y/ N |
Have
You Ever Lived in Santa Monica? Y
/ N |
Phone Number |
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