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Boston Heat Registration/Waiver Form
Players' Name: ______________________________________ Jersey # _____
Address: _______________________________________________________
Sex: M/F Birthday __/__/___ Grade:____ School Attending: ________________
Emergency Contact: ___________________ Relationship to Player: _________
Home Phone: ___________ Work Phone: _____________ Cell Phone: _______
Do the player have any physical or medical problem that we should know about? ( if yes please explain)

The undersigned warrants and represents that he/she is a parent or legal guardian of _______________________________ and that the undersigned possesses the authority to execute this Waiver of Liability/Release of Claims on behalf of Player. The undersigned acknowledges that while at Boston Heat Ahletes AAU Program, the Player will be participating in sporting and recreational activities including without limitation. I understand that many of the acknowledges that he/she has been advised that the Player should be evaluated by his/her physician prior to participating in Boston Heat Ahletes activities. The undersigned further acknowledges and agrees that Boston Heat Ahletes, the owner of the property upon which practice is located, officers, directors, partners, employees, agents and representatives of the foregoing will not be responsible or liable, in any manner, for any injuries, claims, liabilities or damages of any kind which are sustained, suffered or incurred by the Player as a result of his/her participation in playing activities. I hereby authorize the Boston Heat Ahletes, staff and/or representatives to act for me using their best judgement in any emergency requiring medical attention. I also understand that all fees are non-refundable.

I have read the above release and agree to abide by it:

Signature of Parent/Guardian: _______________________________________
Printed Name of Parent/Guardian: ____________________________________ Date: ______
Travel Team ______ Clinic ______ Training _____ Tournament ______

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