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Declaration and Waiver of Liability

Anthem Futsal Waiver and Release of Liability

Player First Name

Player Last Name

Email

I accept terms & conditions

I agree to release all liability, to participate in Anthem/Mad Skillz programs

I agree to allow photos and video to be published on social media outlets or Anthem/Mad Skillz websites

I am not positive of COVID-19 and I have not been in contact with anyone who is in the last 14 days

Parent Signature

Date

I declare that the info I’ve provided is accurate & complete

Phone

Thanks for submitting!

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