Please fill print and fill out this form and bring it with you to your scheduled tryout date

Oregon Fall League presented by Salem Baseball Academy

Individual Participation Waiver

(Note: Submit signed waiver for each participant; copy as needed)

I authorize Salem Baseball Academy to act for me and arrange emergency attention if case of injury. Responsibility for treatment is covered by family insurance. The undersigned acknowledges that attendance and participation in the Oregon Fall League involves a certain risk and accepts full responsibility for those risks including COVID-19. In consideration of being permitted to participate, the undersigned agrees that neither the Academy or its agents, shall be liable on account of any claim arising out of personal injury, illness or death suffered by the undersigned while at attendance at a sponsored Salem Baseball Academy activity. For consideration aforesaid, the undersigned waives, releases, and discharges any and all claims, whether anticipated or unanticipated including without limitation claims based on acts of Salem Baseball Academy or any agent of Salem Baseball Academy
Insurance Company: ___________________________
Policy #: ________ Group #: ________
Subscriber Name: ______________________________
Insurance Company Phone #: ____________________
Parent Contact #: ______________________________
Parent Address: ________________________________
I/We hereby waive and release Salem Baseball Academy or its agents, heirs and assigns, from any and all liability out of or in connection with and participation in the Oregon Fall League.

____________ ____________ Date: , 20

Parent Signature (Type Below) Player Signature