Wra Waiver

Wakefield Recreation Association (WRA)
Youth Sports Registration/Release of Liability
Basketball $20.00 registration fee, -$5 for each additional child
(1st child $20, 2nd $15, 3rd $10 and so on)
Payment to be made at the Wakefield City Building

Name: ______________________________ Date of Birth: ___________

(Print please) Grade: ___________
Parent(s): _______________________________ Phone: ______________
e-mail: _________________________________________________________
Shirt size: Youth S__ M __ L __ Adult S __ Adult M __ Adult L __ Adult XL __

I hereby consent to allow my son or daughter to participate in the WRA Sports program. I also consent not to hold the Wakefield Recreation Association or any of their officers/program volunteers responsible for any injury to my son or daughter. The Wakefield Recreation Association is a volunteer organization and I will not pursue any legal action against any volunteer member of this organization.

Parent’s signature Date