Season: ___________ญญญ__________Team Name: ________________________Coach/Manager’s Name:____________________________
Work Phone: (_____)_______________ Home Phone: (______)_______________E-Mail Address:______________________
I, the undersigned, agree to abide by the rules and regulations of the City of Lewisville Parks and Leisure Services Department in their leagues and agree to Release the City of Lewisville from any injury that might occur to me during league play.

Dated:__________ Coach/Manager’s Signature:______________________________ Church Representative’s Signature:____________________________

NAME (PLEASE PRINT)
ADDRESS/CITY/ZIP
WORK PHONE
HOME PHONE
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