Liability Waiver Form

To enable new & interested players the opportunity to trial playing waterpolo before committing to full registration please read and complete the form below.

Thank you for your response. ✨

Thanks for you interest in training with Moby Dicks Waterpolo club. You have agreed to the following liability waiver: Liability Waiver Form MOBY DICKS WATERPOLO CLUB I am not aware of any injury, illness or other health related issues that would restrict or limit my involvement to train and play waterpolo with Moby Dicks Waterpolo Club. I understand the waterpolo is a dangerous sport and there is risk of personal injury due to the nature of the contact with other players and equipment in the game. I agree to assume all risks and expenses due to an injury that may occur as a result of my involvement with the club practices, games and /or travel to and from said activities. I agree to hold the Moby Dicks Waterpolo Club or anyone acting on its behalf either as a coach, a coaching assistant or administrator harmless in the event of an injury to myself while participating under the supervision of the above. My agreement to the above liability waiver conditions is now recognised when I clicked the submit button on this online form.

Full Name

Phone Number

Please read and tick each box if you agree, then click the submit button:(required)

I am not aware of any injury, illness or other health related issues that would restrict or limit my involvement to train and play waterpolo with Moby Dicks Waterpolo Club. I understand the waterpolo is a dangerous sport and there is risk of personal injury due to the nature of the contact with other players and equipment in the game. I agree to assume all risks and expenses due to an injury that may occur as a result of my involvement with the club practices, games and /or travel to and from said activities. I agree to hold the Moby Dicks Waterpolo Club or anyone acting on its behalf either as a coach, a coaching assistant or administrator harmless in the event of an injury to myself while participating under the supervision of the above. My agreement to the above liability waiver conditions will be recognised when I click the submit button on this online form