2019 Rally Cats Player Waiver

USTA TENNESSEE Rally Cats
Medical Release & Waiver

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Code active until December 31, 2019.

Player Name *

First Name Last Name

Player USTA# *

Player DOB *

Month Day Year

Home Address *

Name
Street Address
City	State
Postal / Zip Code	Country

Parent/Guardian Name *

First Name Last Name

Parent Phone # *

- Area Code Phone Number

Parent Email *

Program Location *

How did you find out about Rally Cats? *

Does your child have his/her own tennis racquet to use at Rally Cats? *

YES NO

USTA Tennessee Photo/Video Release

I hereby give USTA Tennessee and their representatives the irrevocable right to use my name, picture, photograph, or other likeness in all forms and media, and in all manners. This includes but is not limited to print and the web. I waive the right to inspect or approve the finished version (s), including any written copy that may accompany it.

I accept the above consent as written. *

YES NO

USTA Tennessee Release Terms

In consideration of my participation in these tennis activities, I the undersigned, agree to be legally bound, hereby, for myself, my heirs, executors and administrators, waive and release any and all rights and claims for damages I may have against the United States Tennis Association (USTA), the host facility and any and all sponsors and their representatives, successors, and assigns for any and all injuries suffered by me in said event. I have read and understand the foregoing releases, waivers and indemnity agreement.

Include your electronic signature here: *

Date of Signature: *

USTA Tennessee Medical Release Terms

I hereby consent to emergency first aid and other medical procedures, or hospital service that may be rendered by or at accredited hospitals, by appointed physicians, which at the time of injury or illness seem reasonably advisable. I further understand that I will be responsible for payment of any such medical procedures.

Include your electronic signature here: *

Date of Signature: *