Pickleball Release / Waiver form

Phone number *

Birthdate *

Please make sure birthdate (above) reflects accurate year

(defaults to current year)

Gender *

Medical notes

Emergency Contact Name: *

Emergency Contact Relationship: *

Spouse

Mother

Father

Sister

Brother

Son

Daughter

Boyfriend

Girlfriend

Grandfather

Grandmother

Uncle

Aunt

Cousin

Friend

Legal Guardian

Emergency Contact Phone # *

min: 15 / max: 9999999999

Household members

I am in good health and physical condition and fully understand the dangers involved in this type of exercise. I knowingly assume any and all risk, known or unknown to me, associated with my participation in this event. *

I am free of, have not tested positive for, nor have knowingly been in close proximity to anyone with COVID, flu, or similar viral symptoms. *

I understand that my participation in this event could increase the risk of contracting COVID, flu, or similar virus. *

I do hereby release, waive & discharge HUMC and its employees & facilities from any and all claims, demands, actions and judgments for all personal or property injuries caused or arising out of participation in this event. *