Free Agent

Submission of this form indicates that you have read and agree to the terms of our waiver. Waiver/Indemnification: As parent/Legal guardian of the child named herein, I hearby represent that the child has been examined by a pediatrician and is physically fit to participate in Top Bins Only programs. I understand that there are inherent risks participating in this athletic program. I hereby accept responsibility for and agree to pay any and all costs of medical treatment resulting from any injury suffered by my child as a result of his/her participation, and/or representatives from any and all liability, damage, cost or expense arising out of my child's participation, of every kind and nature in Top Bins Only LLC events. In the event that I cannot be reached in emergency, I hereby give permission for care to be administered by a qualified Top Bins Only LLC. staff member, EMT, physician/staff or hospital, or any other qualified individual to provide any medical treatment deemed necessary for my child. As well, I give permission to Top Bins Only LLc to take photos/video of my child participating in the program for various marketing purposes and to send me emails about upcoming events.