NOTE: IN PAYING THROUGH PAYPAL YOU MUST AGREE TO THE FOLLOWING WAIVER I acknowledge the submitted information is correct and as the parent or legal guardian with full responsibility for the care of our child/ custodial child listed, in consideration for the opportunity for our child to participate in a program provided by Breinigsville Youth Association and Play Ball Academy; and intending to be legally bound hereby, the undersigned waives any and all rights of our child, and releases Breinigsville Youth Association and Play Ball Academy, and its coaches relating to and from any all claims or liability that may arise from any injuries or harm suffered by our child caused by or occuring during our child's participation in the program. I grant permission for Breinigsville Youth Association and Play Ball Academy, and its coaches, to provide emergency care for our child as Breinigsville Youth Association and Play Ball Academy deems necessary. The parents/legal guardian shall directly, or indirectly through insurance coverage, assume financial responsibility for any medical charges incurred on behalf of care of our child. By signing below, I give Play Ball Academy permission to use any photographic or video footage of our child for marketing purposes.