Jack Long - ECC Coaches'
Indoor Track and Field Invitational

at New Haven Track & Field Center
Friday, December 21, 2007 - 3:00pm

Waivers and Insurance Information

1. As part of your school’s participation in the Jack Long E.C.C. Coaches Meet, please have your school district insure your athletes for the amount of $1 million dollars for any injuries incurred between the hours of 2:30 pm to 10:30 pm; on December 21st, 2007 at the Jack Long E.C.C. Coaches Meet. Insurance forms should note that the meet is being held in the New Haven Citywide Field House at 480 Sherman Parkway, in New Haven, Connecticut.

2. Fax a copy of this insurance statement to Bacon Academy c/o Steve Browning by December 14th, 2007. (FAX: (860) 537-5410)

3. Have an administrator sign and date a waiver excusing Bacon Academy, the E.C.C. and the New Haven School system from liability. An appropriate school representative may sign the sample provide below.

4. Coaches who cannot complete the waiver form should notify the meet organizer as soon as possible.

Waiver of Liability:

We ________________________ (name of the school/school system) agree to assume full responsibility for the athletes attending the Jack Long E.C.C. Coaches Meet. I will not hold Hillhouse High School; the New Haven School System, The City of New Haven, Bacon Academy or the meet organizers liable or responsible for any injuries or mishaps that happen to coaches or athletes from my school district while I am at this event.

Name of the coach (print): _____________________________________________

Signature of school official: ___________________________________________

Date of signature: ___________________