American Legion Baseball National Form #2

American Legion Baseball
2008 Player Indemnification Agreement Form #2

Please Print or Type

Full Name (First, MI, Last)___________________________________________ Birth Date _____________

Position

P - C - IF - OF

Bat R - L - S

Throws R or L

Height ______

Weight _______

(circle one)

Parent's Address _______________________________________________________________________

Home Phone ___________High School ______________________Enrollment & Year Graduated _______

Include area Code

(Name)

10th, 11th, & 12th

I certify that the information listed above regarding me is correct and I agree to devote my entire service as an American Legion Baseball player this season to ________________________ (Team Name), and I agree to abide by all the rules and regulations of American Legion Baseball. I agree to the sole, exclusive and final jurisdiction and authority of The American Legion National Appeals Board over any, rulings, dispute, disagreement or subject matter having to do with or having any impact or effect upon The American Legion Baseball Program, rules, tournaments, administration or games. Voluntarily and of my own free will, I elect to participate as a member of The American Legion Baseball Team. I understand that the very nature of baseball has its hazards that can cause serious injury and/or death.

Finally, I release, discharge and agree not to take any legal action against the team, sponsor, or The American Legion on which baseball was practiced or played by my team. I further agree that I shall hold harmless and fully indemnify The American Legion, its officers, employees, or any person connected with the team, its agents, coaches, managers.

Player's Signature: _________________________________________ Player's SS # ____/___/_____
Date: ____________________________

(Note: Hospitals require Social Security # for treatment)

Parent's Consent and Release Form

To be signed by parent or guardian. If parents are divorced, this form must be signed by parent having legal custody as established by a court.

I/we have read the player agreement, and release of liability / indemnification agreement above, and agree to allow our son/daughter to participate in American Legion Baseball.
I/we understand and acknowledge and appreciate the risks and dangers involved in allowing our son/daughter to participate in American Legion Baseball and I/we assume all risks of injury and damage incident to his/her participation in American Legion Baseball.
I/we further in consideration of the privilege to play American Legion Baseball, hereby release, discharge and relinquish The American Legion, its officers, agents, their representatives, employees and officials of and from all claims, demands, actions and cause of action of any sort, for any injuries sustained by our son/daughter.
I/we agree to the sole, exclusive and final jurisdiction and authority of The American Legion National Appeals Board over any question, dispute, disagreement or ruling involving our son/daughter or their team.
I/we agree in the event of illness or injury to my son/daughter during an American Legion Baseball game or practice, I/we hereby give consent for the performance of such diagnostic, medical and/or surgical treatment on my child as may be deemed medically necessary in order to assure the safety of my child.

Signature ___________________________________________________ Relationship: ________________

Emergency Contact Person: __________________________ Emergency Phone Number: ________________

Parent's Medical Insurance & Policy Number: __________________________________________________

Date _________ Family Physician & Phone Number _____________________________________________

It is strongly recommended that this form be notarized - most hospitals require consent form to be notarized.

MAKE TWO (2)COPIES 1. TO DEPARTMENT CHAIRMAN 2. TO TEAM MANAGER

American Legion Baseball 2008 Player Indemnification Agreement Form #2

American Legion Baseball
2008 Player Indemnification Agreement Form #2