San Diego Park & Recreation Department
Adult Softball Roster
Day:
Field #:
Team Name:
Type of League: Co-Ed 3 Pitch
Name Address City Zip Home Phone
Check One: All of the above listed players are covered by personal medical or health insurance,
____ therefore are a waiving the Player's Medical Benefit Fund (PMBF)
____We are taking the Player's Medical Benefit Fund at a cost of $37.00 per team.
Manager's Name: ________________________ Day Phone: _______________ Cell #: _______________
Manager's Signature: ________________________ Date: _______________
THIS SECTION MUST BE SIGNED & INITIALED BY ALL PLAYERS LISTED ON THE ROSTER
AGREEMENT AND RELEASE OF LIABILITY:
I, the undersigned, am aware that the ACTIVITY OF SOFTBALL INVOLVES NUMEROUS RISKS OF INJURY, INCLUDING
DEATH, AND I FREELY ASSUME THOSE RISKS. (ALL SIGNATURES BELOW MUST INITIAL):
1._______ 2._______ 3.________ 4._______ 5._______ 6.________ 7._______ 8.________ 9.________10.________
11.______ 12.______ 13._______ 14.______ 15.______ 16._______ 17._______ 18._______19._______ 20._______
I am voluntarily choosing to participate in the City of San Diego Park and Recreation Department adult softball program and related events
and activities. As lawful consideration for permission to participate in the adult softball program and related events and activities, and for
permission to use Park and Recreation Department Facilities, I AGREE TO RELEASE FROM ANY LEGAL LIABILITY AND AGREE NOT TO
SUE THE CITY OF SAN DIEGO, its officers, agents, and employees, and the Amateur Softball Association, its agents, officers, and umpires,
for any and all injuries, including death, or property damage caused by or resulting from my participation in the adult softball program and
related events and activities whether or not such injury, death, or property damage was caused by alleged negligence.
I agree that this AGREEMENT AND RELEASE OF LIABILITY is intended to be as broad and inclusive as is permitted by law. Any provision
found to be invalid or un-enforceasable by a court shall not affect the validity or enforceability of any other provision.
I agree to inspect the facilities and equipment to be used and accept them "as is" or, if I believe any facility or piece of equipment to be
unsafe, I will immediately advise my manager, supervisor, or other person in charge of the activity of the unsafe condition and refuse to
participate in the activity.
I am aware of the rules and policies of this adult softball league. I am aware that violation of the rules or policies could result in my suspension
from the league. I am playing in an amateur league and agree that I shall accept no direct or indirect remuneration for playing in the league.
I AM AWARE THAT THIS CONTRACT IS LEGALLY BINDING AND THAT I AM RELEASING LEGAL RIGHTS BY SIGNING IT. I AM
VOLUNTARILY SIGNING THIS AGREEMENT AND IT IS INTENDED TO BE BINDING ON MY HEIRS, PERSONAL REPRESENTATIVES,
NEXT OF KIN, AND ASSIGNS. THIS SECTION MUST BE SIGNED & INITIALED BY ALL PLAYERS LISTED ON THE ROSTER
AGREEMENT AND RELEASE OF LIABILITY:
* ALL PRINTED NAMES MUST HAVE A CORRESPONDING SIGNATURE *
First and Last Name Signature
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