Dodgeball Liability Waiver
Waiver of Release of Liability
I verify that ___________________________
Participant
has medical insurance with
_____________________________________
Medical Insurance Company
_____________________________________
Policy Number
and has dental insurance with
_____________________________________
Dental Insurance Company
_____________________________________
Policy Number
which effectively covers all medical or dental costs incurred as a result of participation in the HUB Dodgeball League. I acknowledge the potential risk of injury related to participation in dodgeball and the physical activities associated with participation in HUB Dodgeball League. I knowingly and voluntarily, on behalf of the league participant, accept the risk of all such injuries that could occur due to participation in the dodgeball league.
_____________________________________
Signature of Participant/ Guardian
_____________________________________
Print Name of Participant/ Guardian
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