DATE OF BIRTH: STREET ADDRESS: CITY/STATE/ZIP:



Similar documents
Release of Liability. Printed Name of Participant:

CHICAGO RUNNING TOURS & MORE, LLC WAIVER AND RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT PLEASE REVIEW THOROUGHLY BEFORE SIGNING

Street hockey is a dry land variation of ice hockey that can be played all year-round.

PARTICIPANT APPLICATION & RELEASE. * For verification purposes only pursuant to 18 U.S.C et seq.

WESTERN NEW YORK OFFSHORE POWERBOAT ASSOC., INC BUFFALO POKER RUN - AUGUST 7-8, 2015

PEACE DALE SHOOTING PRESERVE RELEASE, WAIVER OF LIABILITY & INDEMNITY AGREEMENT

ARCADIA YOUTH RODEO ASSOCIATION, INC. 124 Heard Street, Arcadia, Florida SEASON MEMBERSHIP APPLICATION

WHEREAS, Participants desire to participate in ALL the recreational activities available at the Trampoline Park; and

Kansas Speedway 400 Speedway Blvd Kansas City KS Ticket Office COMING 70E

Indianapolis Motor Speedway 4790 West 16 th Street Indianapolis IN Ticket Office

RELEASE OF LIABILITY, INDEMNITY, AND BACKGROUND CHECK AUTHORIZATION AGREEMENT

2015 ADF School Medical/Insurance Information & Liability Waivers INSURANCE INFORMATION

Motorcycle RiderCourse WAIVERS

All Students - Please complete items 1-5 All paperwork must have original signatures and be readable. No partial submissions will be accepted.

MOUNTLAKE TERRACE POLICE DEPARTMENT GUEST RIDE-ALONG POLICY AND APPLICATION

SUPERIOR COURT OF CALIFORNIA COUNTY OF LOS ANGELES, STATE OF CALIFORNIA

Amnesty International - Requirements For 2015 Regional Conferences

IMPORTANT: THIS IS A LEGAL DOCUMENT, PLEASE READ AND UNDERSTAND THIS DOCUMENT BEFORE SIGNING

PHOTOGRAPHY/VIDEO SERVICES AGREEMENT

TARLETON SPORTS MEDICINE. Student-Athlete Medical Information

VOLUNTEER ATHLETIC COACHES RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT

How To Volunteer With The City Of Chicago Animal Control

CALIFORNIA Strict Indemnity Language. CALIFORNIA Intermediate Indemnity Language

RYE AIRFIELD 6 AIRFIELD DRIVE RYE, NEW HAMPSHIRE WAIVER, RELEASE OF LIABILITY AND INDEMNITY AND HOLD HARMLESS AGREEMENT PARTICIPANT S NAME

SANTA BARBARA SCHOOL DISTRICTS, SECONDARY EDUCATION INDEPENDENT STUDY PHYSICAL EDUCATION. HOLD HARMLESS AGREEMENT (Agency/Instructor/Coach)

Office Use Only Received On: By:

FOOTBALL CAMPS OF AMERICA, LLC CONSENT FORM

San Antonio Tennis Academy

~LOTUS GUNWORKS OF SOUTH FLORIDA, LLC~ RELEASE, WAIVER, INDEMNIFICATION, HOLD HARMLESS, AND ASSUMPTION OF THE RISK AGREEMENT

2014 Fort Worth Regional Science and Engineering Fair, University of Texas at Arlington, RadioShack. Media Release Form

Insurance Information Insurance coverage

BUSINESS CREDIT APPLICATION

TEXAS A&M INTERNATIONAL UNIVERSITY

RELEASE, WAIVER OF LIABILITY, HOLD-HARMLESS AGREEMENT AND COVENANT NOT TO SUE

2016/17 USA CYCLING COACHING LICENSE APPLICATION 210 USA CYCLING POINT, COLORADO SPRINGS, CO PHONE

TEXAS A&M UNIVERSITY-COMMERCE WAIVER PACKET

Vancouver Pescaderos Dive Club Application for Membership

Initial. Registration Packet. Summer Academy June 3 rd to August 30 th Z M G. HP and TTT Registration Form 1 ZMG Tennis, LLC

CONSENT TO PARTICIPATE IN SCHOOL-SPONSORED SPORTS

Referral Agency and Packaging Agency Agreement

Name of Coach: Qualifications: (Attach resume) Please list qualifications and experiences relating to coaching this activity:

UNIVERSITY OF HOUSTON STUDY ABROAD PROGRAM ACTIVITIES PARTICIPANT S RELEASE AND WAIVER OF LIABILITY AGREEMENT (Form A1) I. RELEASE

I UNDERSTAND THAT THESE RISKS MAY RESULT IN INJURY OR EVEN DEATH.

Child and Youth Group. Volunteer Waiver Form

PARTICIPANT AGREEMENT RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT

TRADEMARK AND COPYRIGHT NOTICES

SUB-PRODUCER AGREEMENT

NPSA GENERAL PROVISIONS

ECKERD COLLEGE RELEASE AND WAIVER: CAMP PROGRAMS PARTICIPANTS

INSTRUCTIONS FOR COMPLETING REGISTRATION. 2. Fill out the forms completely with necessary information and signatures:

SETTLEMENT AGREEMENT AND RELEASE BETWEEN MARK LONG AND THE STATE OF OREGON RECITALS

Santa Monica College Administrative Regulation - Students Activities and Student Conduct

All transportation companies must read, comply, and sign policy below

INDUSTRIAL CARPET CLEANING SERVICES CONTRACT. THIS AGREEMENT executed on this the day of, 20 by and between. (hereinafter "Employer"), and

SEPARATION AGREEMENT AND GENERAL RELEASE. into by and between ( Employee ) and ( the

Math + Leadership Camp at CSUSM Registration Forms

BROKER/AGENT INFORMATION PAGE RETS IDX

Application for Water Service (Commercial)

Tech Judo Open II Invitational Judo Tournament

REGISTRATION, ACKNOWLEDGEMENT, RELEASE AND WAIVER FORM. Full Name: Address:

POLICY CONCERNING SUBMISSION OF IDEAS AND OTHER MATERIALS

How To Get Water From A System

Settlement Agreement & Mutual Release

INDEPENDENT CONTRACTOR AGREEMENT

INDEMNITY AND HOLD HARMLESS AGREEMENT

SETTLEMENT AGREEMENT AND RELEASE

INTERNATIONAL LEADERSHIP OF TEXAS

SETTLEMENT AGREEMENT AND GENERAL RELEASE OF ALL CLAIMS

CLIENT CONTRACT STATE OF TEXAS }

THE GYM, LLC MEMBERSHIP AGREEMENT

MEMBERSHIP/BOAT SUPPORT APPLICATION

Legacy Farm Ltd. TRAINING & BOARDING FACILITY 6950 Gaynor Road Goshen, Ohio Phone: (513) BOARDING AGREEMENT

SETTLEMENT AGREEMENT AND RELEASE OF ALL CLAIMS

FREELANCE PHOTOGRAPHY AGREEMENT

CLIENT AGREEMENT RECITALS

SETTLEMENT AGREEMENT AND MUTUAL GENERAL RELEASE. This Settlement Agreement and Mutual General Release ( Agreement ) is entered into

MISSOURI HIGHWAYS AND TRANSPORTATION COMMISSION ELECTRONIC SIGNATURE AGREEMENT

BOND AGREEMENT: IRREVOCABLE LETTER OF CREDIT FOR COMPLETION OF IMPROVEMENTS

SETTLEMENT AGREEMENT AND RELEASE

MEDICAL LIEN CONTRACT. Date Patient Name Patient Date of Birth Date of Loss

City of Scotts Valley INTEROFFICE MEMORANDUM

TERMS AND CONDITIONS, RIDERS RELEASE OF LIABILITY & ASSUMPTION OF RISK INDEMNITY AND HOLD HARMLESS

THIRD AMENDMENT TO DOMESTIC FACTORING AGREEMENT

Transcription:

Get Noticed Beach Volleyball Waiver WAIVER AND RELEASE, EXPRESS ASSUMPTION OF RISK, INDEMNITY AND HOLD HARMLESS AGREEMENT, AND GRANT OF RIGHTS NAME OF PLAYER: PLAYER AGE DATE OF BIRTH: PLAYER GRADE as of November 16 th 2014 YEAR OF GRADUATION: NAME OF PARENT: PARENT EMAIL ADDRESS: PLAYER EMAIL ADDRESS: STREET ADDRESS: CITY/STATE/ZIP: PARENT PHONES (IN ORDER WE SHOULD CALL): Player s experience playing beach volleyball: TO HAVE INSURANCE COVERAGE, I must sign the GNVB Medical release. I AGREE TO DO SO IMMEDIATELY. OTHERWISE, I ASSUME ALL RISK. I AFFIRM THAT I HAVE READ THIS DOCUMENT AND I UNDERSTAND ITS CONTENTS. I acknowledge that volleyball or any sporting event is an extreme test of a person s physical and mental limits and carries with it the potential for death, serious injury or property loss. With a full understanding of the potential risks, I HEREBY ASSUME THE RISKS OF PARTICIPATING IN OR OFFICIATING A VOLLEYBALL EVENT, PRACTICE, GAME, TOURNAMENT OR TRAINING (hereinafter EVENTS ). In consideration of playing in Get Noticed beach Volleyball, I hereby take the following action for myself, my executors, administrators, heirs, next of kin, successors and assigns: a) I waive, release and

discharge from any and all claims or liabilities for death or personal injury or damages of any kind, which arise out of or are related to my participation in, or my traveling to and from the volleyball event, the following persons or entities: the State of California, City of Huntington Beach, Tamarack Beach Volleyball Club, Team Wave, the coaches, tournament director, sponsors; and the ofbicers, directors, employees, representatives, and agents of any of the above; b) I agree not to sue any of the persons or entities mentioned above for any of the claims or liabilities that have waived, released or discharged herein; c) I indemnify and hold harmless the persons or entities mentioned above from any claims made or liabilities assessed against them as a result of my actions. 1. In full and complete consideration of my ability to participate in any present or future volleyball events, competitions and activities that are operated, organized, sanctioned by or associated with the Get Noticed Beach Volleyball ("ORGANIZER") and any afbiliated training, learning, practicing, competing, spectating, and other associated activities (collectively the "EVENTS") and/or in consideration of my being able to enter into or upon the premises and facilities and locations where said EVENTS are or will be taking place, I, for myself, and on behalf of my personal representatives, heirs, and next of kin (collectively "RELEASING PARTY") hereby acknowledge and agree as follows: WAIVER AND RELEASE AND MEDICAL CONSENT 2. RELEASING PARTY hereby RELEASES, WAIVES, DISCHARGES, AND COVENANTS NOT TO SUE ORGANIZER, any sponsors, advertisers, and organizers of the EVENTS, any other participants in the EVENTS, premises and facilities owners or lessors including the Carlsbad Village Athletic Commission, the State of California, and any city or county therein including The City of Huntington Beach/or each of their afbiliated owners, parents, subsidiaries, licensees, shareholders, ofbicers, directors, managing agents, employees, independent contractors, members, agents, attorneys, investors, afbiliated organizations and entities, or any other persons assisting or participating in their activities, including the EVENTS (collectively the "RELEASEES") FROM ALL LIABILITY OF WHATEVER KIND OR NATURE, IN LAW, EQUITY OR OTHERWISE, WHETHER NOW KNOWN OR UNKNOWN, USPECTED OR UNSUSPECTED, FOR ANY AND ALL PRESENT OR FUTURE LOSS OR DAMAGE, AND ANY CLAIMS, LIENS, DEMANDS, CAUSES OF ACTION, debts, liabilities, expenses including court costs and attorney s fees, SUITS OR JUDGMENTS THEREFROM (collectively the "LIABILITY") ON ACCOUNT OF ANY PERSONAL INJURY, INJURY TO PERSONAL PROPERTY, OR RESULTING IN DEATH ARISING OUT OF OR RELATED TO THE EVENTS or RELEASING PARTY s presence in or upon the premises and facilities and locations where the EVENTS are or will be taking place. This waiver and release includes, without limitation, premises liability and LIABILITY from any cause whatsoever, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES. Such LIABILITY encompasses, but is not limited to, participation

as an active participant or as a spectator, NEGLIGENT RESCUE EFFORTS, and NEGLIGENT enforcement of (or the failure to enact or enforce) rules and regulations. It also encompasses LIABILITY concerning the NEGLIGENT selection, use, or maintenance of any equipment or facility related to the EVENTS. 3. RELEASING PARTY also specibically AUTHORIZES AND CONSENTS TO RELEASEES providing and/or arranging for MEDICAL CARE OR TREATMENT OR EMERGENCY MEDICAL SERVICES OR RESCUE EFFORTS in the event of an emergency or in the event of an injury or medical condition that develops or occurs during participation in the EVENTS or during the RELEASING PARTY s presence in or upon the premises and facilities and locations where the EVENTS are or will be taking place. RELEASING PARTY expressly waives and releases and agrees to hold RELEASEES harmless from and against any and all LIABILITY arising there from. EXPRESS ASSUMPTION OF THE RISK 4. RELEASING PARTY hereby acknowledges and understands that RELEASING PARTY s participation in the EVENTS, including without limitation playing volleyball and engaging in physical exercise and activity, may be VERY DANGEROUS and could result in personal injury, death, and/or property damage. This agreement also constitutes an express and contractual ASSUMPTION OF ALL RISKS AND DANGERS associated with and inherent in the EVENTS which include, but are not limited to, the risk of being struck by objects or equipment and/or making contact with or colliding with other participants, spectators, and natural or manmade objects. The EVENTS will include participants of all skill levels, including both experienced and amateur persons, and RELEASING PARTY expressly assumes the risks associated with mixed and varying skill levels. RELEASING PARTY further acknowledges and understands that there may be undebined and presently unknown risks and dangers associated with the EVENTS and that there may be risks and dangers that may result from the NEGLIGENCE of the RELEASEES, including, without limitation, in providing instruction or guidance, and in the operation or design or maintenance of the premises and facilities and locations where the EVENTS are or will be taking place. Risks and danger may also result, without limitation, in the selection, use, or maintenance of any equipment or facility or service related to the EVENTS. RELEASING PARTY hereby expressly assumes all such risks and dangers whether presently known or unknown. INDEMNITY AND HOLD HARMLESS 5. RELEASING PARTY hereby agrees to DEFEND, INDEMNIFY, SAVE AND HOLD HARMLESS the RELEASEES from any LIABILITY, including from court costs and attorney s fees, arising out of or related to this agreement or RELEASING PARTY s participation in any way in the EVENTS and/or RELEASING PARTY s presence in or upon the premises and facilities where the EVENTS are or will be taking place. RELEASING PARTY also hereby agrees to DEFEND, INDEMNIFY, SAVE AND HOLD

HARMLESS the RELEASEES from any LIABILITY, including from court costs and attorney s fees, caused by or arising out of any statement, action or failure to act by me during or in connection with RELEASING PARTY s participation in the EVENTS, and/or arising out or RELEASING PARTY s tortious or criminal conduct. GRANT OF RIGHTS 6. RELEASING PARTY grants to ORGANIZER, and its successors, licensees and assigns, the revocable right (but not the obligation) to bilm, tape and/or photograph, record, exhibit, edit and otherwise use my name, likeness, voice, conversation, sounds and biographical data on or in connection with the EVENTS in any manner in its sole election and sole discretion. ORGANIZER may use such materials to promote future events. ORGANIZER, and its successors, licensees and assigns, shall be the owner of all rights to said materials, and may use or license the results and proceeds of such materials in all media throughout the world in perpetuity as part of any programming and in the advertising and promotion thereof without limitation or liability. MISCELLANEOUS 7. RELEASING PARTY agrees and understands that this agreement shall be deemed entered into in Huntington Beach, California, and that it shall be governed by and interpreted under the laws of California. 8. RELEASING PARTY represents and warrants that he/she is at least eighteen (18) years of age and has the full, complete and unrestricted right, power and authority to enter into this agreement, to waive and release all matters stated therein, expressly assume all risks and dangers associated with the EVENTS, agree to indemnify the RELEASEES as stated herein, and the grants the rights set forth herein. 9. PARENT / GUARDIAN WAIVER FOR MINORS (Under 18 years old) The undersigned parent and/or natural guardian does hereby represent that he/she is, in fact, acting in such capacity and agrees to save and hold harmless and indemnify each and all of the parties referred to above from all liability, loss, cost, claim or damage whatsoever which may be imposed upon said parties because of any defect in or lack of such capacity to so act and release said parties on behalf of the minor and the parents or legal guardian. 10. RELEASING PARTY HAS READ THIS AGREEMENT, FULLY UNDERSTANDS ITS TERMS, AND UNDERSTANDS THAT THIS IS AN IMPORTANT LEGAL DOCUMENT. RELEASING PARTY FURTHER UNDERSTANDS THAT BY SIGNING THE AGREEMENT HE/SHE IS GIVING UP SUBSTANTIAL LEGAL RIGHTS, INCLUDING THE RIGHTS OF HIS/HER FAMILY. RELEASING PARTY SIGNS THIS DOCUMENT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE, OR

GUARANTEE BEING MADE TO HIM/HER AND RELEASING PARTY INTENDS HIS/ HER SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW. RELEASING PARTY further agrees that no oral representations, statements or inducements, apart from the foregoing written agreement, have been made to him. RELEASING PARTY was given ample opportunity to read the agreement and/or have it reviewed by legal counsel of his/her choice. RELEASING PARTY was also offered a copy of this agreement. The undersigned parent or guardian of the person registered above hereby executes this Waiver & Release for and on behalf of the minor named above. I hereby bind myself, the minor and all other assigns to the terms of the Waiver & Release. I represent that I have legal capacity and authority to act for and on behalf of the minor named herein, and I agree to indemnify and hold harmless the persons or entities mentioned above for any claims or liabilities assessed against them as a result of any insufbiciency of my legal capacity or authority to act for and on behalf of the minor in the execution of the Waiver & Release. PARENT OR GUARDIAN SIGNATURE: DATE