Buckets for Baden Registration Form Baden Street Settlement 13 Vienna St Rochester NY 14605 March 26th 2022 10am-1pm

Are you 18 or Older? Yes No If NO need parental waiver completed and signed 
Waiver Disclaimer:I permit my child to participate in the Buckets for Baden Basketball Event held at 13 Vienna Street on March 26, 2022. Additionally, I permit volunteers to administer first aid treatment and/or allow a physician or hospital to administer treatment to my child in case of emergency. Furthermore, I waive and release all rights, claims, and causes of action I have or may have against Baden Street Settlement of Rochester that may arise as a result of my child’s participation in said event. I allow the Baden Street Settlement Staff to use photographs of my child for official program use without compensation.