Player Name *
Player Name
Player Phone Number
Player Phone Number
Father's Name
Father's Name
Father's Phone Number
Father's Phone Number
Mother's Name
Mother's Name
Mother's Phone Number
Mother's Phone Number
Player Address *
Player Address
Player Birthday *
Player Birthday
Waiver *
In consideration of participating in the activities of the Ironmen Baseball Program, I, the participant’s parent and/or legal guardian, represent that I understand the nature of this Activity and believe the participant to be qualified, in good health, and in proper physical condition to participate in such Activity. I acknowledge that if I believe event conditions are unsafe, I will immediately discontinue the participant’s participation in the Activity. I fully understand that this Activity involves risks of serious bodily injury, including permanent disability, paralysis and death, which may be caused by the participant’s own actions or inactions, those of others participating in the event, the conditions in which the event takes place, or the negligence of the “Releasees” named below; and that there may be other risks either not known to me or not readily foreseeable at this time, and I fully accept all such risks and all responsibility for losses, cost and damages I incur as a result of the participant’s participation in the Activity, including related travel to and from games and/or practices and participant’s activities during free time associated with the Activity. Furthermore, I agree to use my/participant’s personal medical insurance as a primary medical coverage payment if accident or injury occurs. I consent to medical treatment for emergencies that occur during or are related to participant’s participation in the Activity where I am unable to consent to such treatment. I, the participant’s parent and/or legal guardian, hereby release, discharge and covenant not to sue Louisville Lightning Baseball Club, Inc., Chris Burke Baseball, LLC, and The Ironmen Baseball Club, its respective administrators, directors, agents, officers, volunteers, coaches, employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessors of premises on which the Activity takes place (each considered one of the “RELEASEES” herein) from all liability, claims, demands, losses or damages, on my account caused or alleged to be caused in whole or in part by the negligence of the “Releasees” or otherwise, including negligent rescue operations and future agree that if, despite this release, waiver of liability, and assumption of risk, I, the participant’s parent and/or legal guardian, or anyone on my or the participant’s behalf makes a claim against any of the Releasees, I WILL INDENMNIFY, SAVE AND HOLD HARMLESS each of the Releasees from any litigation expenses, attorney fees, loss liability, damage, or cost any Releasee may incur as the result of any such claim. I further give my full permission for the use of participant’s name, picture, image, video, likeness, actions, voice, or other personally identifiable information, in whole or in part, individually or in conjunction with other images, captured by any means as part of participant’s participation in any Activity, in all media , without compensation, reservation or limitation, or further approval, and I agree to indemnify and hold harmless the Releasees for any Claims associated with such grant and right to use. The Releasees are however, under no obligation to exercise any rights granted herein. I have read the WAIVER AND RELEASE OF LIABILITY AND PERMISSION FORM, understand that I have given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid, the balance, notwithstanding, shall continue in full force and effect.