Clinic Waiver

This form must be read and signed before the supervisor and its participants are permitted to take part in all activities &/or events for the "Madison Mallards Kids Clinic at the Ballpark". By signing the agreement, the supervisor affirms having read it.

Release of Liability & Waiver Agreement

In consideration of my participation in the Madison Mallards Kids Clinic at the Ballpark, I acknowledge, appreciate and agree that:

I hereby agree to waive any damages or claim whatsoever that I may have against the Madison Mallards, its members, agents, directors, or servants, as a consequence of any injury to, or death of, the above named applicant, however caused, while participating in any form of the above named activities.

I have read this Release of Liability and Waiver Agreement, fully understand its terms and sign it freely and voluntarily.

Fields marked with an asterisk (*) are required.

Child's Name:	* Please enter child`s name.
Guardian's Name (Printed):	* Please enter Guardian`s Name.
E-Mail:	Please enter a valid email address.
Home Phone:	* (xxx-xxx-xxxx) Please enter a valid home telephone number.
Work Phone:	* (xxx-xxx-xxxx) Please enter a valid work telephone number.
Please enter the security code:	If you can't read the characters in the picture above, click here Please enter a valid security code.