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Murray Parks and Recreation Youth Team Roster PO Box 57520, Murray UT 84157-0520 Phone 264-2614 Fax 264-2507 www.murray.utah.gov Team Team Home Work Email Name Address City Zip Code Birth date Grade Parent’s Signature 1 2 3 4 5 6 7 8 9 10 11 12 If a participant is under 18 years of age, a parent or legal guardian must sign the roster LIABILITY RELEASE AND PERMISSION TO PARTICIPATE In consideration of the acceptance of may application for the above activity, I hereby waive, release, and discharge and all claims for damages for death, personal injury, or property damage which my child may have, or which may hereafter accrue as a result of participation is said event. It is understood that some recreational activities involve an element of risk or danger of accidents, and knowing those risks, I hereby assume those risks. It is further understood and agreed that this waiver, release and assumption or risk is to be binding on my heirs and assigns. I have read and understood the foregoing registration, liability release, and consent to treat form and agree to all of their terms and conditions. Team Manager’s Agreement: As team manager, I understand that the information listed above is accurate to the best of my ability. I realize that my team or player(s) can be removed from participation for falsifying the roster or information needed on this form. Signature Date