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HOSTED BY:
THE FLORIDA COUNCIL ON CRIME AND DELINQUENCY
TO BENEFIT
“THE RUSSELL HOME OF CENTRAL FLORIDA”
A private, non-profit facility for severely handicapped children
&
“LIBBY’S LEGACY BREAST CANCER FOUNDATION”
♦ Our clinic will teach and improve the basic fundamentals of hitting, fielding, and the “mental game”.
♦ Participants will learn from past and present collegiate players, All-Americans, experienced and
knowledgeable travel-ball coaches, former Professional and World Series Champion players.
♦ For girls 13 and up, there will be a coaching session on preparing to play at the College level.
Parent Information
Name: _____________________________e-mail_________________
Home Phone: __________________ cell phone: ____________
Parent’s address: _________________________________
City: __________________ State: __________ Zip: _______
We would like for each player to bring an item from the list below for the Russell Home:
• Laundry detergent
• Liquid dish detergent
• Lysol spray
• Toilet paper
• Paper plates and cups
• Bath wash for boys and girls
• Batteries (AAA, AA, C, D)
• Trash bags large and kitchen size
• Spray deodorants for boys and girls
• Mr. Clean / furniture polish
♦ Please read, sign and return the attached Release, Waiver of Liability.
(note: no player will be allowed to participate without signing the
attached form.)
♦ Include check for $65.00 made payable to Florida Council on Crime and
Delinquency.
Mail completed registration form to:
Cindy Corrado
18725 Sodbury Street
Orlando Fl. 32833
In consideration of the undersigned being permitted on and in the land, building, sports training facility, equipment and real
property owned by ___________________________ (hereinafter the “Property”) and other good and sufficient consideration, the receipt and
sufficiency of which is hereby acknowledged, I, ___________________________________, for my heirs, executors, administrators or
assigns and any persons, firms or corporations in privity with them, and on behalf of and as the parent or legal guardian of any minors
identified below, do now by execution of this document:
2. HEREBY ASSUME FULL RESPONSIBILITY FOR AND ACCEPT ALL RISK OF BODILY INJURY, DEATH
OR PROPERTY DAMAGE DUE TO THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE while I am or any minor
identified below is upon the Property. I and any minor identified below further accept this risk being aware and now acknowledging that any
recreational, athletic, physical or other activity, including but not limited to walking, jogging, running, weight training, pitching, catching,
batting, or playing tennis, in which I or any minor identified below may engage may be dangerous or hazardous to my health or the health of
any minor identified below, and may involve the risk of serious injury and/or death and/or property damage. I and any minors identified
below agree to be fully responsible for inspecting all Property that we may use for any purpose and for being aware of the proper way in
which the activity for which we use the Property should be conducted. I and any minors identified below acknowledge and agree that I
should consult a physician before engaging in any physical activity identified above, and accept the risks associated with and relating to
engaging in the physical activity without first consulting a physician. I and any minors identified below further agree that RELEASEES shall
have no responsibility nor liability for any injuries we may receive due to our failure to properly conduct or perform any activity on the
Property or due to any condition on the Property. We agree to assume all risk while on and using the Property, including any adjacent
property acquired by the RELEASEES after the date of this agreement.
3. HEREBY AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS THE RELEASEES, from and against
all liability, actions, claims, damages, costs, or expenses, including reasonable attorney=s fees, and demands whatsoever, whether in law or
equity, which I or any minor identified below may have, now or in the future, or which our heirs, executors, administrators or assigns
hereafter shall or may have arising out of or in any way connected with our presence on the Property or our use of the Property for any
activity, including but not limited to injuries to the person or property, including death of the undersigned or any minor listed below, before,
during or after our use of the Property of RELEASEES, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR
OTHERWISE, while we are upon the Property of RELEASEES.
I FURTHER EXPRESSLY AGREE THAT THE FOREGOING RELEASE, WAIVER AND INDEMNITY AGREEMENT IS INTENDED
TO BE AS BROAD AND INCLUSIVE AS IS PERMITTED BY THE LAW OF THE STATE OF FLORIDA, IS NOT UNCONSCIONABLE, IS
FULLY ENFORCEABLE IN A COURT OF LAW AND THAT IF ANY PORTION THEREOF IS HELD INVALID, IT IS AGREED THAT THE
BALANCE OF THIS AGREEMENT SHALL, NOTWITHSTANDING, CONTINUE IN FULL LEGAL FORCE AND EFFECT.
I HAVE READ AND VOLUNTARILY SIGNED THIS RELEASE, WAIVER OF LIABILITY AND INDEMNITY AGREEMENT, FOR
MYSELF AND THE MINOR(S) IDENTIFIED BELOW. I UNDERSTAND AND AGREE THAT I CANNOT RELY ON ORAL
REPRESENTATIONS AND/OR STATEMENTS AND I AGREE THAT TO THE EXTENT ANY ORAL REPRESENTATIONS AND/OR
STATEMENTS WERE MADE, THOSE ORAL REPRESENTATIONS AND/OR STATEMENTS ARE UNENFORCEABLE. I UNDERSTAND AND
AGREE THAT THIS WRITTEN AGREEMENT SHALL SUPERCEDE AND REPLACE ALL SUCH ORAL REPRESENTATIONS AND/OR
STATEMENTS.
I HEREBY AFFIRM THAT I AM THE PARENT OR LEGAL GUARDIAN OF THE MINOR(S) LISTED BELOW.
Signed:
By:
Parent or Legal Guardian