DANBURY PAL REGISTRATION FORM - GIRLS AAU BASKETBALL

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Danbury Police Activities League
35 Hayestown Road
Danbury, CT 06811
203-778-4725
Fax: 203-730-2660

THIS REQUIRES A DEPOSIT


YOU WILL BE RE-DIRECTED TO A PAYMENT PAGE WHEN YOU SUBMIT THIS FORM


PARENTAL INFORMATION



To induce the Danbury Police Activities League Inc. to accept registration and permit participation by the above mentioned minor child, I hereby give my permission and consent, agree to release, indemnify, and hold harmless the Danbury P.A.L, its officers, staff, and representatives from any claims arising from any injury to above named minor. I hereby give my consent for emergency care prescribed by duty licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve life, limb, or well-being of my dependent.

This also gives PAL permission to take photography and/or video of said participant for the purposes of promoting programs on fliers, social media, and other ways PAL sees fit.

This is a legally binding electronic signature and REQUIRED
REQUIRED