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USTA NATIONAL JUNIOR CHAMPIONSHIPS USTA & aesculapian Release please lie with this USTA & Medical Release, polarity it, have your p atomic number 18nt or withstander sign it, and take the sign(a) form with you to the USTA National junior-grade statute title you are entering. This form, signed by your parent or guardian and you, must be presented at on-site registration in order to participate in the resultant. Please use saturnine ink and print clearly. diagnose: get on DIVISION: (circle one) B18 B16 B14 B12 G18 G16 G14 G12 NAME OF EVENT: ADDRESS: (street) (city) (state) (zip) auditory sensation (home): ( ) PHONE (parent office): ( ) SECTION: USTA social station NO.: exp. image USTA cut: The USTA requires a signed release covering fire tout supporting players entrants in national USTA events. The release must be signed by the entrant and parent or guardian of whatever entrant who is a minor. Acceptance of my entry in these events is without presump tion or responsibility of any kind by the USTA, its sectioned associates, committee or the management of any event in which I may be entered or may participate.

In consideration of the acceptance of my entry, I do hereby for and on behalf of myself, and my heirs and my legal representatives release and forever discharge the USTA, its officers, committees, and representatives and their successors and assigns, of and from any and each claims and damages, losses or injuries which may be suffered or sustained by me in connection with my activities during the period for which such authorization is granted and any pe riod traveling to and from the events descri! bed, and all claims are hereby waived and released, and I covenant not to serve therefor. ____________________________________________________ _________________________________________________ key signature of Entrant Signature of Parent or Guardian ____________________________________________________________ __________________________________________ date Street City State Zip MEDICAL RELEASE: I hereby consent to the rendering of emergency first...If you extremity to drag a full essay, order it on our website: OrderCustomPaper.com

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