Player Information Form

Please proofread your submission very thoroughly. Just like the when the ball’s in your hands with a few seconds left, you only have one chance to get it right.

Player form

(Contact information will only be used for communications for the 2012 All-Star Labor Classic)
For Use in the Game Program Book
Maximum file size: 1 MB
Allowed extensions: png gif jpg jpeg
Recognition Dinner

Tuesday, March 27th
(5:30pm Photos, 6:00pm Dinner)
The Sprinkler Fitters Local 692 Union Hall
14002 McNulty Road, Philadelphia

Limited to yourself and 2 guests (i.e., 2 parents or 1 parent and coach)

There is no Charge for the dinner.

WAIVER & COMMITMENT TO PLAY

ALL PARTICIPANTS MUST SIGN WAIVER AND COMMITMENT

In consideration of your acceptance of this entry and granting permission for my participation in this event, I hereby intend to be legally bound, for myself, my heirs, executors and administrators, waive and release any and all rights and claims for damages I may now or hereafter have against United Cerebral Palsy of Philadelphia & Vicinity, Philadelphia’s Organized Labor, La Salle University, and any sponsors, coordinating groups and individuals associated with the event, their representatives, successors and assignees, and will hold them harmless from any injuries or damages which I may suffer in this event.

None of the above are responsible for the loss of personal items or other forms of aggravation in connection with this event. I have been warned that I must be in good health to participate in this event and I attest that a licensed physician has verified my good physical condition.

I hereby grant United Cerebral Palsy (UCP) of Philadelphia & Vicinity permission for the unlimited usage of my voice, image, portrait, photograph, in all forms and media for any purpose which will be of value to UCP or to people with disabilities, including publicity, the internet and fundraising. I waive any right to inspect or approve the finished piece therewith, in consideration of what has been agreed upon and acknowledged.

I COMMIT TO PLAY IN THE ALL STAR LABOR CLASSIC ON SUNDAY, APRIL 1, 2012 AT UPPER DUBLIN HIGH SCHOOL.

Parent/Guardian Signature