dilb play-up liability form.docx

Dubuque Independent League Baseball

 “Play Up” Waiver Request Form

DILB allows parents/players to request a WAIVER to allow their player to “play up” into the next age level allowed to them.  Requests and any approval granted are for one playing season only.  Requests are by written application only by the parent or legal guardian.  While DILB does not recommend that players play up, our leadership does recognize that there may be a number of factors, including but not limited to, size, maturity, playing experience and exceptional skills that may warrant a child’s ability to play up.

Player’s Name:_________________________________ Player’s Date of Birth:____________________ Current school year grade:________________________ Requested Grade Level:__________________

Parent’s Name:________________________________________________________________________

Phone Number (Cell):_________________________  Email:_____________________________________

I, the parent/guardian of the above-minor child, hereby request my child to play in an age level older than that assigned and recommended by DILB.  I am aware that my child will be playing against older and potentially more physically developed players with potentially higher level of skills, and I, therefore, recognize the added risks to my child’s health and safety, as well as to my child’s emotional well-being. In signing below, I accept these risks and accept all and every liability and responsibility stemming from such risks as my own, and I absolve DILB, its board members, volunteers, and associated personnel against any claims by or on behalf of the player named above and from any responsibility for the same.  I also acknowledge that I am making this decision on my own initiative and have not been requested to do so by any DILB coach or member.  

INFORMED CONSENT/INSURANCE NOTICE – DILB RECOMMENDS THAT PLAYERS NOT REGISTER TO A TEAM THAT IS NOT IN THE AGE APPOPRIATE LEVEL OF SAID PLAYER. DILB RECOMMENDS ADHERING TO THE AGE RECOMMENDATIONS IN ITS RULES AND REGULATIONS.

It is DILB’s policy that all players compete at an age level they are capable of, both physically and developmentally.  For a player to move up to the next age level available to them requires approval from the DGIL Board of Directors.

Parent/Guardian – Print Name:                                                                                                                      

Parent Signature:                                                                                               Date:                                     

Requested DGIL Team:                                                                                  League:                                  

Approving Coach:                                                                                           Date:                                      

APPROVAL:

DBIL Signature:                                                                                             Date: