Insurance Waiver: The undersigned as a representative of the program or team entered has explained to all players, coaches and
persons associated with the program or team the physical injury risks inherent in competitive sports activities and: 1) represents and guarantees all players are covered under the program/team medical and liability policy, 2) agrees to hereby release and holds harmless the game location site owner, and ICC Tourneys, its employees, agents, officers and volunteers from all liability, claims, expenses, and actions which may arise from injury, harm, and damage caused to the players, coaches, or any person associated with the program/team as a result of tournament or league participation, and 3) assumes responsibility for all medical (incl. emergency) care and subsequent payment for any medical treatment provided to any team member. The undersigned further agrees to indemnify and hold harmless the site owner, ICC Tourneys, its employees, agents, officers, and volunteers for any failure to comply with the forgoing. Any player information found to be incorrect will subject the team to automatic forfeiture. Incomplete forms will not be accepted. Proof of age must be provided upon request.