San Diego Derby Dolls Member Registration Form

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1 San Diego Derby Dolls Member Registration Form Participant Legal Name: Today s Date: Skate Name (optional): Date of Birth: Mailing Address: Phone: Parent/Guardian Primary Contact Name (if minor): Parent/Guardian Relationship (if minor): Parent/Guardian (if minor): Parent/Guardian Phone (if minor): Derby Dolls Program: Adult League Bootcamp Skating Level (New Recruits Only): Beginner Intermediate Advanced Juniors Derby Por Vida Referee Derby Dolls Army Previous Roller Derby Experience & League (Transfers Only): Medical Coverage Type of Primary Coverage: Medical Accident Company: Policy #: Additional Identification # (if app): Primary Doctor Name/Phone: Hospital Preference: Please list any medical conditions that an emergency medical responder may need to know in case of an emergency (asthma, diabetes, epilepsy, past surgery, etc.): List any allergies or allergic reactions to medications: List any medications presently taking: Other pertinent medical information: Emergency Contact Primary Contact Name (first, last): Cell or Primary Phone (including area code): Relationship to participant: Secondary Contact Name (first, last): Cell or Primary Phone (including area code): Relationship to participant: Authorization for Emergency Medical Treatment I, [participant], understand that in the case of illness or injury the San Diego Derby Dolls will try to notify the person I have listed above as an emergency contact. In case of medical emergency, at a time when my listed emergency contact cannot be notified, I grant full power to the Derby Dolls to 1) arrange for the transportation, whether by ambulance or otherwise, to a proper facility where emergency medical treatment would normally be administered, including but not limited to, an emergency room of a hospital, a doctor s office, or a medical clinic; and 2) sign releases as may be required in order to obtain any medical or surgical treatment as is required in the judgment of medical authorities at the facility. Signature of Participant (Parent/Guardian if minor) Date

2 Automatic Credit Card Billing Agreement Roller Derby 360 LLC Authorization Form Please fill out this form for San Diego Derby Dolls (Roller Derby 360 LLC) membership. All requested information is required. Upon approval, we will automatically bill your credit card for the amount indicated below and your total charges will appear on your monthly credit card statement. Bootcamp and Junior skaters will be billed on the 1st of each month and may cancel this automatic billing authorization with a 30-day notice via to Please allow 30 days to process your cancellation request. We do not refund first month of membership or partial months. It is the member s responsibility to alert us if you are no longer attending practice due to injury or wish to resign from the league. Your league resignation must be in writing. League skaters will be billed on the 15th of each month and will be on a six-month renewal. League skaters will be on membership term of Jan 15-July 14 & July 15-Jan 14. League skater memberships may not be cancelled midterm unless participant has one of two special situations: Participant becomes injured to the point she requires surgery. She becomes pregnant. Either situation requires written notice to and may take as long as 30 days to be cancelled. Employee positions with comped dues must fill out a form for future authorization of uniforms and other incidental charges. No incidental charges will ever be authorized without written ( ed) permission. The membership fees are non-refundable. This authorization must be accompanied by a legal ID and proof of health insurance (accident coverage accepted). MEMBERSHIP TYPE (please check one): Bootcamp Skater $80.00 Monthly League Skater $60.00 Monthly League Skater $80.00 Monthly League Skater $40.00 Monthly Junior Bootcamp Skater $50.00 Monthly League Skater $20.00 Monthly Junior Team Skater $65.00 Monthly League Skater $00.00 Monthly Participant s Skate Name: Participant s Legal Name: Card Holder s Name: Card Holder s Billing Address: Type of Credit : VISA MASTERCARD DISCOVER AMEX Credit Card #: Expires (MM/YY): Security Code: Billing Zip Code: Signature: Date: By signing this document you acknowledge that you have read and understand the Roller Derby 360 LLC Automatic Credit Card Billing Agreement above. LEAGUE SKATERS ONLY (please check one): Participant agrees to the following 6-month membership term. If participant starts midterm, she agrees to the remainder of that time. January 15th July 14th or midterm start date July 15th - January 14th or midterm start date

3 Member Code of Conduct Roller Derby 360 LLC/San Diego Derby Dolls All members of the Derby Dolls are responsible for their behavior and are expected to adhere to all policies, rules, and expectations outlined for all Derby Dolls activities and facilities. Members are held individually responsible for the decisions they make regarding their behavior. Any conduct on the part of a member that has or might reasonably have an adverse effect on the proper functioning of the Derby Dolls- or the health, safety, rights or property of Derby Dolls, its members, volunteers, or fans-- is subject to discipline. Being a San Diego Derby Doll and paying monthly dues makes you eligible to try out for a team and/or skate in bouts as a sub-pooler. Being a skating member of SDDD and paying monthly dues is not a guarantee that any member will skate in bouts or be placed on a team. ACCESS TO TRACK Member will have access to the skating track and facilities located at the Dollhouse at th Street, 2nd Floor, San Diego, California, Bootcamp level adults (including officials), Junior Skaters & Army must always have a member of the training team present and may be restricted to scheduled practices only. League level adult skaters may come on their own to the facility at any time as long as they are accompanied by at least one other person who could make a phone call in case of emergency. LEAGUE CONDUCT Participation and Membership in the Derby Dolls is a privilege, which comes with responsibilities. Participation in the Derby Dolls league implies acceptance by every member of the principles of mutual respect for the rights, responsibilities, dignity and well being of others. All members will behave in an appropriate manner when participating in Derby Dolls activities or facilities. Code of Conduct in Derby Doll attire is also enforced during, but not limited to, fundraisers, promotions, and appearances on TV or radio. NO LEAGUE MEMBER SHALL: Be guilty of an abusive verbal attack or physical attack (hit, push, shove, strike, or threaten to strike) including unnecessarily rough tactics (hit with malice) upon any player, official, league member or spectator. NO LEAGUE MEMBER SHALL: Appear upon the track (or on skates) at any time in an intoxicated condition. Drugs and alcohol use while on skates during practice (scheduled or unscheduled), games, or while working in an official capacity will not ever be tolerated. NO LEAGUE MEMBER SHALL: Be guilty of discussing in a derogatory or abusive manner in any public forum, any play, decision, or his/her personal opinion of other players or league members. NO LEAGUE MEMBER SHALL: Intentionally destroy or threaten destruction of property, equipment or grounds. NO LEAGUE MEMBER SHALL: Publicly present obscene behavior. All Derby Dolls public events are family friendly and must be presented in a PG manner including: bouts, public parties, PR events, media appearances and any event that involves ticket sales. Audible swearing, obscene gestures, mooning and other inappropriate adult behavior will not be tolerated at any public Derby Dolls event/activity. PLAYER CONDUCT Be courteous to leaguemates, opposing teams and officials. Players who display disrespectful conduct towards other participants may be immediately sanctioned. Refrain from intimate physical contact with other participants during practices or games. Treat everyone fairly (Derby Dolls or Non-Derby Dolls), regardless of gender, age, place of origin, color, sexual orientation, religion, political belief, economic status, team, or skating ability. OFFICIAL/REFEREE CONDUCT Know the rules and their interpretation and administer them. Be impartial in all decisions. Act in a professional and businesslike manner when acting in an official capacity of the league. Strive to provide a safe and sportsmanlike environment in which players can properly display their skating skills. Physical violence and verbal abuse will never be tolerated.

4 MEMBERS UNDER 21 Will not be permitted to skate at any venue or function where the requirements are 21 and up. Cannot consume alcohol at any Derby Dolls function. This includes, but is not limited to: San Diego Derby Dolls events, Derby Dolls Member house parties, home or away bouts, and any gatherings with other Derby Dolls Members. It is the responsibility of the Derby Doll Members under 21 years of age to not accept or consume alcohol at any time. Should a Derby Dolls Member who is under 21 years of age consume alcohol at a Derby Dolls function, the underage member may be expelled from Derby Dolls. Should any Derby Dolls Member provide alcohol to a Derby Dolls Member who is under 21 years of age, the San Diego Derby Dolls Member who provided the alcohol may be expelled from San Diego Derby Dolls. CONCURRENT LEAGUE MEMBERSHIP A skater cannot belong to more than one league unless special arrangements have been made between the two leagues and approved in writing by the General Manager. A skater may not sub or bout for another league/non-sddd team without written approval from GM. Trainings events are excluded from this clause, i.e. black & white scrimmages, training camp bouts & RollerCon events. PUBLIC IMAGE AND REPRESENTATION Members of the Derby Dolls are expected to uphold the values, missions and goals of the League. This prohibits speaking negatively of the League and its members and business partners in a public forum, including but not limited to broadcast, print and online interviews, as well as on publicly-viewable social media pages and personal blogs. The League and representatives of the League further protect players and other League members, to the best of their ability, from defamation, slander or false representation in print, broadcast or other media as it applies to the Derby Dolls, skaters and Roller Derby 360 LLC. Derby Dolls league members may not represent the Derby Dolls at any event, broadcast, photo shoot or other non-derby endeavor paid or unpaid without clearance from General Manager. PENALTIES FOR VIOLATING THE CODE OF CONDUCT League leadership (Captains, Co-Captains, Internal Relations and the General Manager) will act responsibility in monitoring and enforcing penalties. Derby Dolls reserves the right to enforce penalties on a case-by-case basis, if necessary. SANCTIONS Sanctions will be imposed individually, progressively or jointly for any violation of the expectations of members. Derby Dolls/Roller Derby 360 LLC may impose one or more sanctions for any violation of membership expectations or guidelines. Verbal and/or written warning from a designate. Temporary exclusion from a Derby Dolls function, program, activity and/or facility. Formal reprimand, which outlines expected future behaviors, any specific requirements for the member s return to the league, and future possible sanctions for further violations or breaches. Permanent removal from any and all Derby Dolls functions, programs, activities and/or facilities. Further actions through any and all existing policies and procedures governing conduct and behavior. Derby Dolls reserves the right to revoke a membership immediately after a single violation. SANCTION PROCEDURE If a member of the league believes a violation of the code of conduct has recently occurred, he/she must write a grievance statement within four weeks of said incident detailing the incident and what elements of the Code of Conduct were violated, and submit it to the C.o.C. Review Group: Skater Representative, Internal Relations Head and/or General Manager. CODE OF CONDUCT AGREEMENT The undersigned league member has individually read, understands, and agrees to adhere to issued Code of Conduct. The undersigned states that he/she clearly understands that violating the Code of Conduct may cause the league member to be suspended for a specified period of time under the Sanctions, or to forfeit his/her member status. Printed Participant Legal Name Skater name Participant Signature Date: Parent/Guardian Signature (if Minor) Date:

5 ROLLER DERBY 360 LLC - Participant Waiver & Release of Liability Agreement In consideration of Roller Derby 360 LLC, 3401 Adams Avenue, Suite A83, San Diego, CA ( Roller Derby 360 ) allowing (legal name printed - hereinafter referred to as Player ) to participate in Roller Derby 360 LLC (San Diego Derby Dolls) roller derby events to be held in San Diego and other locations during the current season (e.g. January 1, 2015 to December 31, 2015) (the Derby Season ), where Roller Derby 360 will furnish services, a premises for the Derby Season to enable Player to participate in the Derby Season, and other good and valuable consideration, receipt of which Player hereby acknowledges, Player agrees as follows retroactive to January 1, Player fully understands and acknowledges that: (i) participating in the Derby Season, playing the sport of roller derby, and/or using Player s equipment, or any third party s equipment (collectively the Equipment ), during the Derby Season, involves hazardous and dangerous activities whereby Player is likely to (unintentionally and/or intentionally) be exposed to extreme and hazardous conditions; (ii) the risk of injury, loss and/or damage to Player and/or property is significant; (iii) Player s participation in such activities and/or use of the Equipment may result in Player s injury, illness or death, including but not limited to bodily injury, disease, strains, fractures, partial or total paralysis, eye injury, blindness, permanent disability, heat stroke, heart attack, death or other ailments that may cause serious disability; (iv) these risks and dangers may be caused in whole or in part by: (a) the negligence or other conduct of: (1) Roller Derby 360, its parent, subsidiaries, related and affiliated entities, and its and their members, shareholders, partners, officers, directors, employees, consultants, contractors, vendors, agents, representatives, licensees, successors, and assigns (collectively the Released Parties ), (2) other Derby Season players, participants, and volunteers and (3) others (including, without limitation, spectators), (b) accidents, (c) breaches of contract, (d) forces of nature, and (e) other causes; (v) these risks and dangers may arise from foreseeable or unforeseeable causes; and (vi) by participating in the Derby Season and/or using the Equipment, Player hereby voluntarily assumes all risks and dangers and accepts any and all risks of participating and therefore accepts all responsibility for any such injuries, losses and/or damages. In addition, Player hereby gives permission for Roller Derby 360 to authorize emergency medical treatment as it may be deemed necessary by Roller Derby 360 for Player. Player acknowledges that Roller Derby 360 may contract with licensed chiropractors, chiropractic students, massage therapists, acupuncturists, and other experts in related fields in regards to, or related to, health care, (hereinafter health care staff ), to offer services in their respective areas of expertise. Player acknowledges that the health care staff services are contracted for on a volunteer basis. Player acknowledges that the health care staff that is available to Player are not licensed Doctors of Medicine (otherwise known as M.D. s), that Roller Derby 360 makes no representations as to quality of care provided, and that Player is not required to use the health care staff which is available for any purposes, including but not limited to rehabilitation of injuries, chiropractic services or any other service which the health care staff may offer. Player hereby acknowledges that any treatment sought or received through the health care staff is at their own risk, and that any medical related advice or treatment is to be followed up with Player s own licensed M.D.. Player hereby releases Roller Derby 360, as well as the contracted health care staff, from any liability for injury or damage to herself that may arise from any medical related treatment, advice, chiropractic services, or any other health care related services which she may receive from the health care staff. By executing this Waiver and Release of Liability Agreement, Player hereby agrees that Player will not bring, institute or assert any rights or claims in connection with the Derby Season, and/or any other media in connection with the Derby Season, and therefore absolutely, unconditionally and forever covenants not to sue, and waives, releases, discharges, holds harmless and indemnifies, the Released Parties from and against any and all claims, demands, controversies, causes of action, damages, losses, rights, liabilities and obligations (including, without limitation, reasonable attorney s fees) whatsoever, whether known or unknown, that Player and/or any third party may suffer, arising out of or pursuant to: (i) any injuries and/or damages to property, whether due to Player s own actions or due to the actions of any third party; (ii) the negligence of the Released Parties or otherwise; and/or (iii) Player s participation in the Derby Season and/or other media in connection with the Derby Season (collectively Claims ), including, without limitation, Claims relating to rights of privacy or publicity, personal injury, property damage, wrongful death, loss of services, economic losses, or medical or other expenses. Player also acknowledges that Roller Derby 360 shall not be obligated to obtain any further consent from any other party regarding Player s involvement in the Derby Season or any other media (except for the Parental/Guardian Consent if Player is a minor). ACCEPTED AND AGREED: (Skate Name Print) Player s Legal Name - Print Age/Date of Birth/Phone/ Player s Legal Name - Sign Date Address City, State Zip PARENTAL/GUARDIAN CONSENT FOR MINORS: I (we) hereby represent that I am (we are) the parent(s) or legal guardian(s) of the minor ( Player ) (a minor is less than eighteen years old) and that I (we) consent to Player entering into this Release of Liability Agreement and agree to have Player be bound by the terms hereof, and for all renewals hereof. In addition, I (we) hereby give permission for Roller Derby 360 to authorize emergency medical treatment as it may be deemed necessary by Roller Derby 360 for Player. Parent(s)/Legal Guardian(s) Sign Name Print Name Date Address/City/Zip/Phone/ Revised 1/19/15

6 ROLLER DERBY 360 LLC - Participant Media License Agreement In consideration of Roller Derby 360 LLC, 3401 Adams Avenue, Suite A83, San Diego, CA ( Roller Derby 360 ) allowing (print legal name) also known by skate name (print skate name) (collectively Player ) to participate in Roller Derby 360 (San Diego Derby Dolls) roller derby league events to be held in San Diego and other locations during the current season (e.g. January 1, 2015 to December 31, 2015 referred to herein as the Derby Season ), furnishing Player with services, and premises for the Derby Season (presently th Street San Diego, CA 92101), Player enters into this Agreement as of January 1,2015, agrees to render her services for and in connection with the Derby Season on a schedule to be set by Roller Derby 360 on reasonable prior notice, and hereby grants to Roller Derby 360 during the term that Player renders her playing services hereunder in connection with the Derby Season and/or any Series (as hereinafter defined), the irrevocable, worldwide, and exclusive right and license to photograph, videotape, film, and/or record Player, and the irrevocable, worldwide and exclusive right and license, in perpetuity, to Player s skate name, approved likeness (such approval not to be unreasonably withheld), voice, approved biography (such approval not to be unreasonably withheld), all of Player s activities in connection with the Derby Season and its activities (including, without limitation, an interview if requested and scheduled with Roller Derby 360 and approved by Player), and any still photographs, film, videotape and/or other recordings thereof in connection with the Derby Season (collectively the Material ) for use in: (i) the Derby Season; (ii) any and all other now known or hereafter existing or devised uses, media and/or forms, including, without limitation, exploitation in all forms of television, motion pictures, internet/web casting, publishing, videocassette/dvds, and all ancillary, subsidiary and derivative rights therein (collectively referred to as the Program ); (iii) all the advertising, promotion, marketing, merchandising directly or indirectly related to Roller Derby 360, and/or the Derby Season in any way whatsoever, and (iv) the production, distribution and other exploitation of the Derby Season and the Program, with the understanding of the parties that Roller Derby 360 s authority to enter into any distribution deals hereunder shall be exercised by Nili Goldfarb in her total discretion. Notwithstanding anything to the contrary contained hereinabove, Player may license her legal name, likeness, voice, biography and other aspects of herself, for any use whatsoever, except in connection with any other roller derby activities during the Derby Season. Player may not license (i) her name and likeness in connection with any publishing, merchandising or other uses involved with roller derby in any way whatsoever during the term of this Agreement, (ii) any of Company s logos or trademarks, including, without limitation, Roller Derby 360, and/or San Diego Derby Dolls in perpetuity, and (iii) may not appear in any sports and/or sports-related reality television programming, without the express written approval of Roller Derby 360, in its sole discretion, during the term of this Agreement. Player acknowledges and agrees that Player (i) shall not knowingly say or do anything either during the Derby Season or at any other times that would denigrate or defame Roller Derby 360, the Derby Season or anyone connected to the Derby Season, in any way whatsoever; (ii) will abide by the terms of Roller Derby 360 s current Code of Conduct (as revised from time to time, and subject to change throughout the term of this agreement by Roller Derby 360 in its sole discretion), which, when approved by Roller Derby 360, shall be incorporated into this Agreement by reference; (iii) will remain in good physical condition as is relevant to participate during each season of the Derby Season pursuant to this Agreement, including, without limitation, providing Roller Derby 360 with accurate, current physical reports on any injuries by and through the Heads of the Training Team, Captains, and/or relevant personnel (hereinafter Captains ) as applied to Player, with the understanding that a knowing violation of this rule shall be cause for immediate suspension by Roller Derby 360 and revocation of all skating privileges during the Derby Season. IT IS THE OBLIGATION OF PLAYER TO BE FAMILIAR WITH THE CURRENT VERSION OF THE CODE OF CONDUCT IN EFFECT. During the term of this Agreement, Player may play with other teams as a guest skater for an unlimited number of occasions upon Roller Derby 360 s prior approval by Nili Goldfarb, it being understood that the Player s name and skating services are exclusive to Roller Derby 360 during each Season in which Player skates for Roller Derby 360 hereunder. Merchandising/Sponsorship/Appearance Revenue: Roller Derby 360 LLC may enter into appearances, sponsorships and merchandising agreements on behalf of its members, which shall include a royalty paid to Roller Derby 360 LLC of Ten Percent (10%) of any net revenue derived by Player from each such agreement, so long as the Player s net revenue, as defined below, exceeds Two Thousand ($2000) U.S. Dollars quarterly. In the event that Player elects to secure her own sponsorship/merchandising agreements, such agreements may not conflict with and/or be competitive to Roller Derby 360 s sponsorship agreements, are subject to Roller Derby 360 s approval, which shall not be unreasonably withheld, and shall include a royalty paid to Roller Derby 360 of Ten Percent (10%) of any net revenue derived by Player from each such agreement, so long as the Player s net revenue, as defined below, exceeds Two Thousand ($2000) U.S. Dollars quarterly. Roller Derby 360 shall own all trademarks and copyrights, including, without limitation, all renewals and/or extensions thereof, in and to the Derby Season (including, without limitation, the name Derby Dolls, and the name of any and all teams in Roller Derby 360 s league) and the Material, including, without limitation, all the results and proceeds of Player s participation in the Derby Season and the Series, in perpetuity, throughout the world, in any manner, and in any and all now known or hereafter existing or devised uses, media and/or forms, including, without limitation, exploitation in all forms of television, motion pictures, internet/web casting (including, without limitation, all its web sites), publishing, videocassette/dvds, and all ancillary and subsidiary rights therein. All such results and proceeds, including without limitation, material of all types written, created, or furnished by Player, shall be deemed to be works-made-for-hire specially commissioned by Roller Derby 360 for Roller Derby 360 under U.S. copyright laws. Accordingly, Roller Derby 360 is and shall be considered the sole author, and, at all stages of completion, the sole and exclusive owner of said results and proceeds and Material (collectively referred to as Player s Material ) and all right, title and interest therein (including, without limitation, all copyrights, trademarks and related rights, and all extensions and renewals thereof, neighboring rights, and any and all other ownership and exploitation rights in the results and proceeds now or hereafter recognized in any and all territories and jurisdictions worldwide). If, as the result of any law or legal decision, Player is deemed to acquire any rights to the results and proceeds (including, but not limited to, any copyrights therein), Player hereby assigns and transfers all such rights to Roller Derby 360, including, without limitation, all copyrights and trademarks, renewals and extensions thereof. By executing this Agreement, Player: (i) hereby waives any right to privacy or publicity, whether granted by statute or common law, that Player may have in connection with Player s Material, the Derby Season and/or Series, or any other use; (ii) agrees that Player will not bring, institute or assert any rights or claims in connection with Player s Material, the Derby Season, the Series, or any other use; and (iii) absolutely, unconditionally and forever covenants not to sue, and waives, releases, discharges, holds harmless and indemnifies, the sponsors and advertisers of the Series and/or the Derby Season, the Revised 1/19/15

7 lessor(s) of the premises for the Derby Season, and Roller Derby 360, its parent, subsidiaries, related and affiliated entities, and its and their members, shareholders, partners, officers, directors, employees, consultants, contractors, vendors, agents, representatives, licensees, successors, and assigns (collectively the Released Parties ), from and against any and all claims, demands, controversies, causes of action, damages, losses, rights, liabilities and obligations (including, without limitation, reasonable attorney s fees) whatsoever, whether known or unknown, arising out of or pursuant to any claims that Player or any third party may have relating to copyright, trademark liability, rights of privacy or publicity, personal injury, property damage, wrongful death, loss of services, economic losses, or medical or other expenses, or any other personal or proprietary rights, excluding any claims arising solely out of Roller Derby 360 s contractual obligations to third parties. Player acknowledges that Roller Derby 360 shall not be obligated to (i) obtain any consent from any other party regarding Player s involvement in the Series (except for the Parental/Guardian Consent if Player is a minor), the Derby Season or the use of Player s Material or (ii) exercise any or all the rights granted to Roller Derby 360 hereunder. This Agreement, and all matters or issues material thereto, will be governed by and construed in accordance with the laws of the State of California applicable to agreements made and fully performed in California. This Agreement constitutes the entire agreement between the parties, shall supersede and replace any and all other representations, warranties or agreements, or written between the parties, and shall be binding upon and shall inure to the benefit of the parties hereto, and their respective heirs, executors, administrators, personal representatives, licensees, assigns and successors, and cannot be modified without the written approval of both parties. If any provision of this Agreement is found prohibited or unenforceable in any jurisdiction, it will, as to such jurisdiction, be ineffective to the extent of such prohibition or unenforceability without invalidating the remaining provisions of this Agreement, and any such prohibition or unenforceability in any jurisdiction will not invalidate or render unenforceable such provision in any other jurisdiction. To the extent permitted by law, the parties waive any provision of law that renders any such provision prohibited or unenforceable in any respect. The parties hereby consent to the exclusive jurisdiction of the state and federal courts of California in Los Angeles County over any action, suit or proceeding arising out of or relating to this Agreement. Player s remedies in the event of a dispute relating to or arising out of this Agreement, or its termination, or expiration, shall only be an action at law against Roller Derby 360 for monetary damages (excluding any incidental, consequential, special or punitive damages). Player shall not be entitled to terminate or rescind this Agreement, or seek an injunction or other equitable relief against, and/or to enjoin and/or restrain Roller Derby 360, or to proceed against any other party in any way related to this Agreement. In the event of Player s breach of this Agreement, Roller Derby 360 may elect to suspend or terminate Player immediately, and Player shall forfeit any future share of net revenue granted Player hereunder, notwithstanding that in such event, Roller Derby 360 shall reserve all of its other rights and remedies. Roller Derby 360 shall have the right at any time to assign its rights and/or obligations under this Agreement, in whole or in part, in any manner and to a studio, production company, or broadcast network or other financially-responsible third party. Player shall not have the right at any time to assign any rights or delegate any obligations under this Agreement, and any attempted such assignment or delegation shall be null and void ab initio and constitute a material breach hereof. Player shall keep confidential this Agreement, the terms hereof, and Roller Derby 360 s business operations, trade secrets, or other data of a similar nature or description in connection with the Derby Season. Player agrees not to use, sell, license, disclose or communicate to any person, firm, or corporation, in any manner, any such confidential information, except as may be permitted by Roller Derby 360. PLAYER UNDERSTANDS THAT SHE HAS GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING THIS DOCUMENT, SIGNS IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. Player intends that this agreement is to be a complete and unconditional release of all liability and rights contained herein to the greatest extent allowed by the law. ACCEPTED AND AGREED: (Skate Name Print) Legal Name Print: Signature: DATE: PLAYER PARENTAL/GUARDIAN CONSENT FOR MINORS: I (we) hereby represent that I am (we are) the parent(s) or legal guardian(s) of the minor (legal name) ( Player ) (a minor is less than eighteen years old) and that I (we) consent to Player entering into this Agreement and agree to have Player be bound by the terms hereof. Parent(s)/Legal Guardian(s) Print Parent(s)/Legal Guardian(s) - Signature Date: Revised 1/19/15

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