Team Roster and
Waiver Form
	Field Hockey Extravaganza
Sponsored by Sports Dynamics and Four Seasons
This “completed” roster form must be turned in to the tournament committee prior to
 your team’s first game.  If not, all games played before roster is turned in will not count.	

Year:____________	
_________________________________________________________________________________________________________________________________________________________________

PARENT’S WAIVER: I, the undersigned parent, certify that my child, named adjacent to my signature, has my permission to participate in the games and related activities of Field Hockey Extravaganza tournament.   I acknowledge and understand that field hockey is a dangerous sport and that there is a possibility of injury to my child.  In consideration for my child’s participation in the game of field hockey,  I hereby release, acquit and forever discharge indemnity, and hold harmless from any and all claims, demands, actions or causes of action for liability for damages arising out of, or in any way related to, my child’s participation in field hockey tournament play, Sports Dynamics ,Four Seasons, and all of its officers, directors, tournament representatives, employees, agents, volunteers and representatives.
NOTICE: The Field Hockey Extravaganza does not provide any form of medical coverage.  Insurance coverage is the responsibility of the participating teams

ALL PARTICIPANTS PLAY AT THEIR OWN RISK!    THIS AUTHORIZATION IS IN EFFECT FOR THE PERIOD OF ACTIVE TOURNAMENT PLAY ONLY.
	
TEAM NAME
	AGE GROUP
	•	BOYS                  PARENT ORGANIZATION                                        
•	GIRLS	
COACH CONTACT NAME
	ASSISTANT’S NAME
	
COACH/CONTACT ADDRESS
	ASSISTANT’S ADDRESS	
PHONE (H)	(W)	CELL:
	PHONE (H)	(W)	CELL:	
E-MAIL
		E-MAIL		
#	PLAYER’S NAME	ADDRESS & ZIP	D.O.B.	PARENT’S SIGNATURE	DATE	

						

						

						

						

						

						
Participants 18 and older may sign the Release Form