BARANGAY MALITAM

MALITAM BASKETBALL LEAGUE

WAIVER
I ________________________________ , ______ years old and currently residing at
Barangay ________________________, Batangas City, assume all risks inherent in these
activities and accept full responsibility for all damages or injuries of any kind.
I certify that I am physically fit and have not been advised to not participate by a qualified medical
professional.

I certify that there is no health- related reasons or problems which preclude my participation
in this Malitam Basketball League. I acknowledge that this waiver will be used by the organizers of
the Malitam Basketball League in which I may participate and that it will govern my actions and
responsibilities in the said activity.

I certify that I have read this document and fully understand its content. I am aware that this
is a waiver form and I sign it on my free will.

The undersigned parent and or natural guardian does hereby represent that he/she is, in
fact, acting in such capacity, has consented to his/her child or ward’s participation in the Mayor’s
Cup Season 17, and has agreed individually and on behalf of the child or ward, to the terms of the
form set forth above.

Signature Over Printed Name of Parent/ Guardian

Date Signed: ____________________________