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Walton County Parks and Recreation Adult Basketball Team Team Home Work/Cell PLAYER NAME BIRTHDATE ADDRESS CONTACT NUMBER SIGNATURE 1 2 3 4 5 I acknowledge that the Walton County Parks and Recreation Department does not carry insurance on participants in programs. Being aware of this and acknowledging that participation in any activity involves a certain degree of risk or injury, I hereby waiver, release, absolve, indemnify and agree to hold harmlessthe Walton County Parks and Recreation Department, their board of directors, employees, coaches, instructors, officials and volunteers from any and all liability arising out of any injury suffered by the above said participant during this activity. I understand that the above named parties will not assume responsibility for payment of medical treatment or transportation to from the place of treatment. Only minor first aid will be administered when necessary. I further agree to abide by the policies and procedures set forth by the Walton County Parks and Recreation Department. I agree that the player information above is accurate. Signature (TEAM MANAGER)