Laurens Central School
      2010 Waiver of Liability & hold harmless agreement

I certify that my child __________________________ is of normal health and capable of participating in the Laurens Booster Club’s 3 on 3 basketball tournament on March 20, 2010. 
I, _________________________ do hereby covenant and agree to release and hold harmless the Laurens Central School District from and against any and all liability, loss, damages, claims or actions from bodily injury and/or property damage arising out of participation in this event. I hereby authorize the Laurens Booster Club to obtain medical treatment for my child, in the event that the child’s emergency contacts cannot be reached.

Emergency Contacts:

1.    ______________________________________ (phone)

       ______________________________________ (Full Name)

2.    ______________________________________ (phone)

______________________________________ (Full Name)

Signature of Parent/Guardian ________________________________ Date_________

All students, regardless of age, MUST have the waiver signed by a parent/guardian.

           
Laurens Central School
      2010 Waiver of Liability & hold harmless agreement

I certify that my child __________________________ is of normal health and capable of participating in the Laurens Booster Club’s 3 on 3 basketball tournament on March 20, 2010. 
I, _________________________ do hereby covenant and agree to release and hold harmless the Laurens Central School District from and against any and all liability, loss, damages, claims or actions from bodily injury and/or property damage arising out of participation in this event. I hereby authorize the Laurens Booster Club to obtain medical treatment for my child, in the event that the child’s emergency contacts cannot be reached.

Emergency Contacts:

1.    ______________________________________ (phone)

       ______________________________________ (Full Name)

2.    ______________________________________ (phone)

______________________________________ (Full Name)

Signature of Parent/Guardian ________________________________ Date_________

All students, regardless of age, MUST have the waiver signed by a parent/guardian.