Dodgeball Waiver

Have you registered for this event? Completing this “Wavier” alone DOES NOT register you to play in this event.

Which event are you playing in? *

Team Name *

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First Name *

Last Name *

Email Address *

You email will be used, in the event we need to contact you about this event.

Street / Address

City *

State / Province *

Country

Zipcode *

MEDICAL RELEASE: In the event that I am unconscious or otherwise unable to make medical decisions for myself in an emergency, I hereby give permission for medical treatment, and related transportation, to any licensed physician, surgeon, clinic, hospital or ambulance service to secure proper treatment, and to order anesthesia, for myself as named above. I am allergic to the following medications:

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If you are human, leave this field blank.