LEAGUE ROSTER FORM

I ACKNOWLEDGE THAT I HAVE READ AND THAT I UNDERSTAND EACH AND EVERY ONE OF THE PROVISIONS IN THIS

WAIVER, RELEASE OF LIABILITY AND INDEMNIFICAITON AGREEMENT AND AGREE TO ABIDE BY THEM. I AGREE TO

PLAY WITH THE ABOVE MENTIONED TEAM FOR THE PLAYING SEASON OR UNTIL RELEASED BY SAID CLUB,

ACCORDING TO THE RULES AND REGULATIONS OF THE CITY OF REYNOLDSBURG, PARKS & RECREATION

DEPARTMENT.

Player Name (print)           Street Address            City      Phone #                 DOB         Signature

1__________________________________________________________________________________

2__________________________________________________________________________________

3____________________________________________________________________________________

4__________________________________________________________________________________

5___________________________________________________________________________________

6___________________________________________________________________________________

7___________________________________________________________________________________

8___________________________________________________________________________________

9_____________________________________________________________________________________

10___________________________________________________________________________________

11____________________________________________________________________________________

12____________________________________________________________________________________

13____________________________________________________________________________________

14____________________________________________________________________________________

15____________________________________________________________________________________

 

I, _______________________________, being the manager of the above team, do hereby certify that all signatures on this official team

roster are original and that failure to have the player personally sign the roster may subject the manager and player to suspension.

_______________________

Manager’s signature