Head Coach's Name *

First Name

Last Name

Head Coach's Phone *

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Assistant Coach's Name *

Only One Assistant Is Allowed On The Bench With Team

First Name

Last Name

Asst. Coach's Phone *

(###)

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Head Coach's Name *

First Name

Last Name

Phone *

(###)

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Assistant Coach's Name *

First Name

Last Name

Phone

(###)

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Head Coach's Name *

First Name

Last Name

Phone

(###)

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Athlete's Name *

First Name

Last Name

Athlete's Name (Sibling)

First Name

Last Name

Parent or Guardian's Name *

First Name

Last Name

Parent or Guardian's Name (2)

First Name

Last Name

Phone

(###)

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Phone (2)

(###)

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Liability Waiver *

I understand and acknowledge that my participating athlete/team may incur personal or bodily harm while participating in sports-related activities, including but not limited to activities described as running, jumping, physical contact, etc. By submitting this agreement, I assume all risks inherent in these activities and accept full responsibility for any and all damages or injuries of any kind. I further acknowledge that to minimize the risk of injury, my participating athlete agrees to obey all safety rules and to report fully any problems related to his/her physical condition to a 55Buckets Coach or Trainer as soon as the problem arises

I do hereby release 55Buckets, J-one Training, The Gauntlet, Forza, Box2U directors, staff, employee’s agents and/or volunteers and agree to hold them harmless from all claims whatsoever arising from the conduct of any person(s) which results in the injury or loss to my participating athlete.

Athlete's Name *

First Name

Last Name

Parent's or Guardian's Name *

First Name

Last Name

Phone *

Country

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Parent's or Guardian's Name (2)

First Name

Last Name

Phone

(###)

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