108 Old Veechdale Rd | PO Box 378 |
Simpsonville, KY 40067 | Phone: 502.722.8110 | Fax: 502.722.8119

City of Simpsonville KY

Registration Form

General Details
Participant Details
Participant Details
Parent/Guardian Information

Release/ Waiver of Liability

I/We the parent(s) or legal guardian(s) of the above named minor hereby give approval for participation in any and all practices, games, and other activities related to the League.

I/We understand that participation in recreational sports may result in serious injury and that protective equipment and other measures do not always prevent injuries.

I/We hereby waive, release, absolve, indemnify, defend, and agree to hold harmless the City of Simpsonville, Municipal Building Corporation, its advisory committee, Simpsonville City Officials, Agents, Employees, Representatives, Parks Board, league organizers, sponsors, supervisors, and participants from activities for any claim arising out of injury to my/our child whether the result of negligence or any other cause.

Additional Information

After you click submit you will be redirected to PayPal to finalize your submission. Please note, your registration is NOT complete until after you submit your payment! Be sure to put your last name on your PayPal registration!