WAIVER AND RELEASE OF LIABILITY (Grace Chapel)

I hereby consent to participate in the Lexington Pickleball Club. Pictures and videos may be taken of me for advertisement and/or promotion of programs and/or email marketing for the Lexington Pickleball Club. 

 I further agree to release and find harmless the Lexington Pickleball Club, the Town of Lexington, their officers, employees, volunteers, agents, and attorneys from any and all liability or expenses arising out of any incident involving, or on account of any injury to the above-named person in connection with such program. 

 In signing this waiver, I agree to release and discharge, indemnify, and hold harmless Grace Chapel Leadership located at 3 Militia Drive in Lexington, MA, their Trustees and Partners from and against any and all liabilities, claims, actions, costs and expenses in any way relating to or arising out of activities at Grace Chapel in Lexington. 

 I hereby give permission to the Town of Lexington Recreation and Community Programs Department staff and those associated with the Lexington Pickleball Club and Grace Chapel in Lexington to provide and administer immediate first aid and authorize a physician at a local hospital to secure proper treatment for me as named below if the need arises.

 I HAVE READ THIS RELEASE CAREFULLY.

 I FULLY UNDERSTAND ITS CONTENTS, AND VOLUNTARILY AGREE TO ITS TERMS.

Sign in to Google to save your progress. Learn more
Email *

Please sign with your full name:

*

Date

*
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy