Bay Area Field Hockey Waiver
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BAFHA WAIVER
Fill out this form and enter Print Form to submit an e-copy as well as print out and attach to copy of your USFHA card.

Club Name/BAFHA Affiliation: Participation Level:
First Name: M.I. Last Name:
Address: City:
State: Zip:
Please include Area Code!!
Phone # (daytime): Phone # (Eve/Weekend ):
Email: USFHA # USAFH expiration date:
Lifetime members enter 12/31/2099 for date.
BY CHECKING THIS BOX, I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT , FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
For members under 18 years of age
Parent/Guardian Information      
First Name: Last Name:

CLink Please check if address is the same as above:

Address: City:
State: Zip:
Phone # (daytime): Phone # (Eve/Weekend ):
Email:    

SIGN AND Paste Copy of USFHA Membership Card on Printout

 

Participant

 

Guardian (if participant is under 18).


PASTE: