Mail-in Registration Form
PRINT THIS FORM AND MAIL IT TO:
Chelmsford Police Athletic League, 2 Olde North Road, Chelmsford, MA 01824
 

Name of Participant:                                          Age:                        DOB:
Name of Parent(s)/Guardian(s):                                                         Grade:
Address:
Emergency Phone: #1                                       #2
Email Address:

Please note that we are unable to accommodate any coaching or team requests at this time.

Waiver Form
(By checking this box and signing below you are agreeing to the terms of the Waiver Form.)

I, the undersigned and parent/guardian of __________________________________ do hereby release and discharge CPAL, the Chelmsford Police and its agents, employees, officers, referees, and facilities from all claims, demands, actions, and judgments which I have, or claim to have, against the above for all personal injuries, and to all injuries to property, both real and personal, incurred by my child caused by, or arising out of, participation in games, practices, or other functions sponsored by CPAL, the Chelmsford Police, its agents, employees, and officers.

My child has no physical condition that would prevent him/her from participating in the games, practices, or programs sponsored by CPAL and the Chelmsford Police. My child is in good health and physical condition. I fully understand the dangers involved in this type of exercise, function, competition, and practice.

The Chelmsford Police recommend all participants have a physical health examination prior to participation in the League. Consult your doctor if you are unsure about your childís ability to participate in this type of activity. While rules exist to control play, this is a contact sport and contact should be expected.

It is the responsibility of the individual participantís parent/guardian to maintain his/her childís health and accident insurance. CPAL, The Greater Lowell Dek Hockey League, the Chelmsford Police and its agents, employees, and officers accept no responsibility in this matter. I, as a parent/guardian of _______________________ accept all risk regarding my childís participation in this League. I also authorize any member of the Chelmsford Police Department to provide any treatment for injury or medical emergency in case of my absence.
 


Signature of Parent/Guardian          Printed Name of Parent/Guardian             Date