Release/Waiver and Personal Conduct Agreement
Please read this carefully so you fully understand this notice and its contents and agree to its terms.
RELEASE/WAIVER PORTION

FOR YOU OR YOUR MINOR CHILD, AS PARTICIPANT IN THIS PROGRAM, YOU AGREE:

I have chosen to participate in this event sponsored by the City of Loris Recreation Department. I understand that this program has risks of injury and damage to person and property ranging from slight to severe, as with such physical games and sports. I undertake that risk of my own free will and understand that I alone am responsible for my safety while I am either preparing to play, or engaging in play, or am otherwise on or near the premises where the program takes place.

By signing this Waiver, or checking the box on the web form, I am indicating that I understand these facts, and that I am participating in this activity at my own risk. I further represent that I have undertaken to prepare myself for this program, and I have not received any medical or other professional advice to abstain because of my health or physical condition. I know of no reason why I should not participate in this program. If I am injured in any way during the conduct of this program, I authorize the City of Loris to seek whatever medical attention may appear to be necessary, and I will be financially responsible for such care.

I further agree that I release and hold harmless the City of Loris, its agents, employees, officials, and representatives, from all injuries and losses that I may sustain as a result of my voluntary participation in this event.

PERSONAL CONDUCT PORTION
It is expected that players representing Loris Recreation do so with integrity and sportsmanship. Players may be removed from present and future Loris Recreation sports and/or programs for behaviors that put Loris Recreation in a negative appearance. This may include but is not limited to cursing, fighting, social media posts, illegal acts, making fun of another player, etc. In addition, players that sign up to participate are expected to follow through with their obligation by showing up to practices and games regularly and on time when allowed and by supporting their teammates. We are Loris, and we are all in this together.
MEDICAL PORTION
Please list any medical conditions that may affect child’s participation in this program:
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Agreement (Required – Please Check the Box Below and Sign and Date): 

	I have carefully read the above Release, Waiver, and Personal Conduct Agreement. I Agree.	

Child’s Name: _______________________________________________________________

Parent/Guardian Signature: ____________________________________________________

Date: ______________________________________________________________________