“Great American”

Dodgeball Tournament

Saturday, April 8, 2017

Lehman Catholic High School

5:30PMCheck-in Registration Open

6:00PMTournament and Concessions Open

$50/team pre-registration OR $60/team at the door

Pre-registration Deadline:Friday, March 31, 2017

Send completed registration to:

Lehman Catholic HS – Teen Leadership Corps

2400 St. Marys Ave., Sidney, OH 45365

Team Name: ______

Player Names (maximum 10 members per team):

  1. ______
  2. ______
  3. ______
  4. ______
  5. ______
  6. ______
  7. ______
  8. ______
  9. ______
  10. ______

Contact Person:______

Mailing Address: ______

City: ______State: ______Zip Code: ______

Phone (______) ______Email: ______

Emergency Contact Name: ______Phone (_____) ______

Payment: Please indicate payment method:

Cash ____ Check #______payable to Lehman Catholic TLC (Teen Leadership Corps)

Questions: Contact Melissa Safreed at Lehman Catholic High School

(937) 773-8747 or (937)498-1161

Registration return: Lehman Catholic TLC “Dodgeball” – 2400 St. Marys Ave., Sidney, OH 45365

Event Information: Lehman Catholic High School Teen Leadership Corps will be hosting the Dodgeball Tournamenteventon Saturday, April 8, 2017 at Lehman Catholic High School. There will be food and beverages available to purchase. The winning team will receive t-shirts. The purpose of this event is to raise funds to defray the cost of a remote/motorized flag for our school gymnasium.

EVENT DISCLAIMER:By adding your signature, you accept this waiver and disclaimer. Waiver and Release: By participating in the Event, I do so at my own risk. I assume all risk of injury, illness, damage or loss to me or my property that might result, including without limitation, any loss or theft or personal property. I consent to medical treatment in the event of injury, accident, and/or illness during the Event. I agree on behalf of myself (and my personal representatives, heirs, executors, administrators, agents, and assigns) to release and discharge Lehman Catholic High School, its principles, its officers and directors, its employees, all sponsors and their representatives and employees from any and all claims or causes of action (known or unknown) arising out of their negligence. I acknowledge that I have carefully read this “Waiver and Release” and fully understand that it is a release of liability. By my signature below, I am waiving any right that I may have to bring legal action to assert a claim against Lehman Catholic High School for its negligence. I hereby grant full permission to any and all of the foregoing to use my name and likeness in any broadcast, telecast, video or print media reporting or advertising of the Event without compensation.

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