Hanover - Horton 4th of July Celebration
July 3rd, 2010
Perrine Park, Downtown Hanover Male - grade going into/Female - grade completed Player Name Grade Phone number
1.____________________________________________________________________________
Each player, or parent/guardian, if under 18 years of age is required to sign a waiver before playing in the HANOVER-HACKER. (Waiver is on page 2 or the backside of this form).
Make checks payable to:
Mail to: Village of
Be sure all waiver forms are signed before mailing (see backside of this form or page 2).
For more information call: 517-563-2839
Registrations accepted until Saturday, July 3 at 10 a.m.
Extra forms available at Hanover Market
Double Elimination - Court Monitors
4 players per team, t-shirts to first 25 teams registered
Cost $50 per team
Division I - Grades five and six*
Division II - Grades seven and eight*
Division III - Grades nine and ten*
Division IV - Grades eleven and twelve
Division V - Open
Team Name ________________________________________________
Division____________________________________________________
2.____________________________________________________________________________
3.____________________________________________________________________________
4.____________________________________________________________________________
NAME OF PLAYER______________________________________________________________________
Waiver: In consideration of the acceptance of my entry, I, for myself, my executors, administrators and assigns do hereby release and discharge the Village of Hanover and Hanover-Horton 4th of July Committee, its agents representatives or affiliates, and any of all other sponsors jointly and severally, for any and all claims of injuries or damages incurred by me as a result of or in connection with said event. I attest and verify that I have full knowledge of the risks involved in this event and am physically fit and trained to participate in this event. NAME OF PLAYER______________________________________________________________________
Waiver: In consideration of the acceptance of my entry, I, for myself, my executors, administrators and assigns do hereby release and discharge the Village of Hanover and Hanover-Horton 4th of July Committee, its agents representatives or affiliates, and any of all other sponsors jointly and severally, for any and all claims of injuries or damages incurred by me as a result of or in connection with said event. I attest and verify that I have full knowledge of the risks involved in this event and am physically fit and trained to participate in this event.
Signature_____________________________________________________________________ (Parent or guardian if under 18 years of age)
NAME OF PLAYER______________________________________________________________________
Waiver: In consideration of the acceptance of my entry, I, for myself, my executors, administrators and assigns do hereby release and discharge the Village of Hanover and Hanover-Horton 4th of July Committee, its agents representatives or affiliates, and any of all other sponsors jointly and severally, for any and all claims of injuries or damages incurred by me as a result of or in connection with said event. I attest and verify that I have full knowledge of the risks involved in this event and am physically fit and trained to participate in this event.
Signature____________________________________________________________________(Parent or guardian if under 18 years of age)
Signature______________________________________________________________________________ (Parent or guardian if under 18 years of age)
Signature_____________________________________________________________________(Parent or guardian if under 18 years of age)
NAME OF PLAYER_______________________________________________________________________________
Waiver: In consideration of the acceptance of my entry, I, for myself, my executors, administrators and assigns do hereby release and discharge the Village of Hanover and Hanover-Horton 4th of July Committee, its agents representatives or affiliates, and any of all other sponsors jointly and severally, for any and all claims of injuries or damages incurred by me as a result of or in connection with said event. I attest and verify that I have full knowledge of the risks involved in this event and am physically fit and trained to participate in this event.
