Consent Form and Waiver of Responsibility This consent form must be signed by a parent or guardian before application will be accepted.
__________________________________ Signature of parent/guardian __________________ Date
Lake Mills
Lakeside Lutheran Woodland Beach Rd. Hwy 18
9 y8
As parent or guardian of the aforementioned child, I hereby give my approval and permission for her to participate in any and all activities and certify she is in good health and is able to participate in all activities. In case of emergency I grant permission for her to be treated by a licensed physician if necessary at ____________________________(your hospital) or at a local hospital in the event I am not available and medical treatment is required. We/I have read the above and consent to the terms stated.
I-94
Hw
I agree that on behalf of the enrolled applicant named on this registration form, representatives of the Windmill Softball Program and/or the coaches, officials, playing areas, or persons transporting my child to and from games or other activities associated with the Windmill Softball Program, will not be held responsible or liable for any injury, accident or loss of property however caused. It is further agreed that all risks involved in participating in said program are assumed by the participant and her parent or guardian, who is responsible for the medical fitness of the applicant and for all medical costs incurred in case of injury while in attendance.
lakeside lutheran high school
North
Need Directions? from the north:
warrior windmill softball for girls ages 5–High School May–July 2015
Take I-94 to Hwy 89 at Lake Mills (exit 259) Take Hwy 89 south, almost all the way through town Look for golf course on left, then turn right on Woodland Beach Road Lakeside is on the right
from the south: Take Hwy 18 or Hwy 12 to Hwy 89 Take Hwy 89 north into Lake Mills Just inside city limits, turn left on Woodland Beach Road Lakeside is on the right
__________________________________ Signature of parent/guardian __________________ Date
windmillfastpitchsoftball.com