MINOR RELEASE. AND I, THE MINOR’S PARENT AND/OR LEGAL GUARDIAN, UNDERSTAND THE NATURE OF BUCKS FUTSAL ACTIVITIES AND THE MINOR’S EXPERIENCE AND CAPABILITIES, AND I BELIEVE THE MINOR TO BE QUALIFIED, IN GOOD HEALTH, AND IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN SUCH ACTIVITY. I HEREBY RELEASE, DISCHARGE, AGREE AND PROMISE NOT TO SUE, AND AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS EACH OF THE RELEASE'S FROM ALL LIABILITY CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON THE MINOR’S ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE "RELEASES" OR OTHERWISE, INCLUDING NEGLIGENT MEDICAL ASSISTANCE OR RESCUE OPERATION AND FURTHER AGREE THAT IF, DESPITE THIS RELEASE, I, THE MINOR, OR ANYONE ON THE XXXXX’S BEHALF MAKES A CLAIM AGAINST ANY OF THE RELEASES NAMED ABOVE, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE, OR COST ANY MAY INCUR AS THE RESULT OF ANY SUCH CLAIM. I acknowledge the contagious nature of communicable diseases, in particular the COVID 19 Coronavirus and that the United States Center for Disease Control (CDC) and many other public health authorities still recommend practicing social distancing. I further understand that Upper Southampton Academy, Inc., DBA Bucks Futsal has put in place recommended preventative measures that are intended to reduce the spread of communicable diseases including but not limited to COVID 19. I further understand that Upper Southampton Academy, Inc., DBA Bucks Futsal CAN NOT guarantee that I will not become infected with communicable diseases. I understand that the risk of becoming exposed to and/or infected by communicable diseases may result from the actions, inadvertence, omissions, or negligence of myself and others, including, but not limited to, staff, guests and other clients and their families. I voluntarily seek services provided by Upper Southampton Academy, Inc., DBA Bucks Futsal, and acknowledge that I could be increasing my risk to exposure to communicable diseases including but not limited to COVID 19. I understand that I must comply with all required procedures that are intended to reduce the spread diseases while I am attending Upper Southampton Academy, Inc., DBA Bucks Futsal. I promise at all times that I am on the Upper Southampton Academy, Inc., DBA Bucks Futsal facility premises, the following will be true: * I am not experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell. * I have not traveled internationally within the last 20 days. * I have not traveled to a highly impacted area within the United States of America in the last 14 days. * I do not believe I have been exposed to someone with a suspected and/or confirmed case of any communicable diseases including but not limited to COVID 19. * I have not been diagnosed with any communicable diseases, or I have been cleared as noncontagious by state or local public health authorities. * I am following all Center for Disease Control recommended guidelines as much as possible pertaining to Coronavirus and I am limiting my exposure to communicable diseases, in particular but not limited to COVID 19. I hereby release and agree to hold Upper Southampton Academy, Inc., DBA Bucks Futsal harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act of Upper Southampton Academy, Inc., DBA Bucks Futsal or that may otherwise arise in any way in connection with any services received from Upper Southampton Academy, Inc., DBA Bucks Futsal. I understand that this release discharges Upper Southampton Academy, Inc., DBA Bucks Futsal from any liability or claim that I, my heirs, or any personal representatives may have against Upper Southampton Academy, Inc., DBA Bucks Futsal with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any services received from Upper Southampton Academy, Inc., DBA Bucks Futsal. This liability waiver and release extends to the facility together with all owners, partners, employees, and associates. By signing below, I agree to all terms stated in this agreement document above without exception. PLAYER NAME PRINTED: PARENT/GUARDIAN NAME PRINTED: PLAYER SIGNATURE: PARENT/GUARDIAN SIGNATURE:
Appears in 1 contract
MINOR RELEASE. AND And I, THE MINOR’S PARENT AND/OR LEGAL GUARDIANthe minor’s parent and/or legal guardian, UNDERSTAND THE NATURE OF BUCKS FUTSAL ACTIVITIES AND THE MINOR’S EXPERIENCE AND CAPABILITIES, AND I BELIEVE THE MINOR TO BE QUALIFIED, IN GOOD HEALTH, AND IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN SUCH ACTIVITY. I HEREBY RELEASE, DISCHARGE, AGREE AND PROMISE NOT TO SUE, AND AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS EACH OF THE RELEASE'S FROM ALL LIABILITY CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON THE MINOR’S ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE "RELEASES" OR OTHERWISE, INCLUDING NEGLIGENT MEDICAL ASSISTANCE OR RESCUE OPERATION AND FURTHER AGREE THAT IF, DESPITE THIS RELEASE, I, THE MINOR, OR ANYONE ON THE XXXXX’S BEHALF MAKES A CLAIM AGAINST ANY OF THE RELEASES NAMED ABOVE, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE, OR COST ANY MAY INCUR AS THE RESULT OF ANY SUCH CLAIM. I acknowledge understand the contagious nature of communicable diseasesactivity and the minor’s experience and capabilities and believe the minor to be qualified, in particular the COVID 19 Coronavirus and that the United States Center for Disease Control (CDC) and many other public health authorities still recommend practicing social distancing. I further understand that Upper Southampton Academy, Inc., DBA Bucks Futsal has put in place recommended preventative measures that are intended to reduce the spread of communicable diseases including but not limited to COVID 19. I further understand that Upper Southampton Academy, Inc., DBA Bucks Futsal CAN NOT guarantee that I will not become infected with communicable diseases. I understand that the risk of becoming exposed to and/or infected by communicable diseases may result from the actions, inadvertence, omissions, or negligence of myself and others, including, but not limited to, staff, guests and other clients and their families. I voluntarily seek services provided by Upper Southampton Academy, Inc., DBA Bucks Futsalgood health, and acknowledge that I could be increasing my risk in proper physical condition to exposure to communicable diseases including but not limited to COVID 19. I understand that I must comply with all required procedures that are intended to reduce the spread diseases while I am attending Upper Southampton Academy, Inc., DBA Bucks Futsal. I promise at all times that I am on the Upper Southampton Academy, Inc., DBA Bucks Futsal facility premises, the following will be true: * I am not experiencing any symptom of illness participate in such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell. * I have not traveled internationally within the last 20 days. * I have not traveled to a highly impacted area within the United States of America in the last 14 days. * I do not believe I have been exposed to someone with a suspected and/or confirmed case of any communicable diseases including but not limited to COVID 19. * I have not been diagnosed with any communicable diseases, or I have been cleared as noncontagious by state or local public health authorities. * I am following all Center for Disease Control recommended guidelines as much as possible pertaining to Coronavirus and I am limiting my exposure to communicable diseases, in particular but not limited to COVID 19activity. I hereby release release, discharge, covenant not to xxx, and agree to indemnify and save and hold Upper Southampton Academy, Inc., DBA Bucks Futsal harmless from, and waive on behalf each of myself, my heirs, and any personal representatives any and the releasee’s from all causes of action, liability claims, demands, damageslosses, costs, expenses and compensation for damage or loss damages on the minor’s account caused or alleged to myself and/or property that may be caused in whole or in part by any actthe negligence of the "releasees" or otherwise, including negligent rescue operation and further agree that if, despite this release, I, the minor, or failure to act anyone on the minor’s behalf makes a claim against any of Upper Southampton Academythe releasees named above, Inc.I will indemnity, DBA Bucks Futsal or that may otherwise arise in any way in connection with any services received from Upper Southampton Academysave, Inc., DBA Bucks Futsal. I understand that this release discharges Upper Southampton Academy, Inc., DBA Bucks Futsal and hold harmless each of the releasees from any liability litigation expenses, attorney fees, loss liability, damage, or claim that cost any may incur as the result of any such claim. PHOTO/VIDEO RELEASE I, my heirsor the minor’s parent and/or guardian, or any personal representatives may have against Upper Southampton Academyread and agree to the forgoing provisions. Pinnacle Sports reserves the right to use photographs, Inc.negatives, DBA Bucks Futsal with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise fromreproductions and video tapes from events held at, or in connection toconjunction with, any services received from Upper Southampton Academy, Inc., DBA Bucks Futsal. This liability waiver and release extends to the facility together with all ownersfor display, partnerspublication, employeesmarketing, advertising and associatesother purposes without the need to compensate me or my minor or without additional approval. By signing belowNegatives and videotape will be the exclusive property of Pinnacle Sports. I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I agree to all terms stated in this agreement document above without exceptionHAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND HAVE SIGNED IT FREELY AND WITHOUT INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT. PLAYER NAME PRINTEDPrinted Name of Participant: PARENTDate of Birth: Address: City: State: Zip: Phone: E-mail: Participant’s Signature (only if age 18 or over): Date: Printed Name of Parent/GUARDIAN NAME PRINTEDGuardian: PLAYER SIGNATUREDate: PARENTParent/GUARDIAN SIGNATURE:Guardian Signature (only if participant is under the age of 18): REFUND POLICY
Appears in 1 contract
MINOR RELEASE. AND And I, THE MINOR’S PARENT AND/OR LEGAL GUARDIANthe minor’s parent and/or legal guardian, UNDERSTAND THE NATURE OF BUCKS FUTSAL ACTIVITIES AND THE MINOR’S EXPERIENCE AND CAPABILITIES, AND I BELIEVE THE MINOR TO BE QUALIFIED, IN GOOD HEALTH, AND IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN SUCH ACTIVITY. I HEREBY RELEASE, DISCHARGE, AGREE AND PROMISE NOT TO SUE, AND AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS EACH OF THE RELEASE'S FROM ALL LIABILITY CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON THE MINOR’S ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE "RELEASES" OR OTHERWISE, INCLUDING NEGLIGENT MEDICAL ASSISTANCE OR RESCUE OPERATION AND FURTHER AGREE THAT IF, DESPITE THIS RELEASE, I, THE MINOR, OR ANYONE ON THE XXXXX’S BEHALF MAKES A CLAIM AGAINST ANY OF THE RELEASES NAMED ABOVE, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE, OR COST ANY MAY INCUR AS THE RESULT OF ANY SUCH CLAIM. I acknowledge understand the contagious nature of communicable diseasesactivity and the minor’s experience and capabilities and believe the minor to be qualified, in particular the COVID 19 Coronavirus and that the United States Center for Disease Control (CDC) and many other public health authorities still recommend practicing social distancing. I further understand that Upper Southampton Academy, Inc., DBA Bucks Futsal has put in place recommended preventative measures that are intended to reduce the spread of communicable diseases including but not limited to COVID 19. I further understand that Upper Southampton Academy, Inc., DBA Bucks Futsal CAN NOT guarantee that I will not become infected with communicable diseases. I understand that the risk of becoming exposed to and/or infected by communicable diseases may result from the actions, inadvertence, omissions, or negligence of myself and others, including, but not limited to, staff, guests and other clients and their families. I voluntarily seek services provided by Upper Southampton Academy, Inc., DBA Bucks Futsalgood health, and acknowledge that I could be increasing my risk in proper physical condition to exposure to communicable diseases including but not limited to COVID 19. I understand that I must comply with all required procedures that are intended to reduce the spread diseases while I am attending Upper Southampton Academy, Inc., DBA Bucks Futsal. I promise at all times that I am on the Upper Southampton Academy, Inc., DBA Bucks Futsal facility premises, the following will be true: * I am not experiencing any symptom of illness participate in such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell. * I have not traveled internationally within the last 20 days. * I have not traveled to a highly impacted area within the United States of America in the last 14 days. * I do not believe I have been exposed to someone with a suspected and/or confirmed case of any communicable diseases including but not limited to COVID 19. * I have not been diagnosed with any communicable diseases, or I have been cleared as noncontagious by state or local public health authorities. * I am following all Center for Disease Control recommended guidelines as much as possible pertaining to Coronavirus and I am limiting my exposure to communicable diseases, in particular but not limited to COVID 19activity. I hereby release release, discharge, covenant not to xxx, and agree to indemnify and save and hold Upper Southampton Academy, Inc., DBA Bucks Futsal harmless from, and waive on behalf each of myself, my heirs, and any personal representatives any and the releasee’s from all causes of action, liability claims, demands, damageslosses, costs, expenses and compensation for damage or loss damages on the minor’s account caused or alleged to myself and/or property that may be caused in whole or in part by any actthe negligence of the "releasees" or otherwise, including negligent rescue operation and further agree that if, despite this release, I, the minor, or failure to act anyone on the minor’s behalf makes a claim against any of Upper Southampton Academythe releasees named above, Inc.I will indemnity, DBA Bucks Futsal or that may otherwise arise in any way in connection with any services received from Upper Southampton Academysave, Inc., DBA Bucks Futsal. I understand that this release discharges Upper Southampton Academy, Inc., DBA Bucks Futsal and hold harmless each of the releasees from any liability litigation expenses, attorney fees, loss liability, damage, or claim that cost any may incur as the result of any such claim. PHOTO/VIDEO RELEASE I, my heirsor the minor’s parent and/or guardian, or any personal representatives may have against Upper Southampton Academyread and agree to the forgoing provisions. Pinnacle Sports reserves the right to use photographs, Inc.negatives, DBA Bucks Futsal with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise fromreproductions and video tapes from events held at, or in connection toconjunction with, any services received from Upper Southampton Academy, Inc., DBA Bucks Futsal. This liability waiver and release extends to the facility together with all ownersfor display, partnerspublication, employeesmarketing, advertising and associatesother purposes without the need to compensate me or my minor or without additional approval. By signing belowNegatives and videotape will be the exclusive property of Pinnacle Sports. I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I agree to all terms stated in this agreement document above without exceptionHAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND HAVE SIGNED IT FREELY AND WITHOUT INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT. PLAYER NAME PRINTEDTeam Name (if applicable): Printed Name of Participant:_ Date of Birth: PARENTAddress: City: State: Zip: Home Phone: Cell: Email: Participants Signature (only if age 18 or older): Date: Printed Name of Parent/GUARDIAN NAME PRINTEDGuardian: PLAYER SIGNATUREDate: PARENTParent/GUARDIAN SIGNATURE:Guardian Signature (only if participant is under the age of 18): REFUND POLICY
Appears in 1 contract
MINOR RELEASE. AND And I, THE the MINOR’S PARENT AND/OR LEGAL GUARDIANParent and/or Legal Guardian, UNDERSTAND THE NATURE OF BUCKS FUTSAL ACTIVITIES AND THE MINOR’S EXPERIENCE AND CAPABILITIESunderstand the nature of the Activities and the Minor’s experience and capabilities and believe the Minor to be qualified, AND I BELIEVE THE MINOR TO BE QUALIFIEDin good health, IN GOOD HEALTH, AND IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN SUCH ACTIVITYand in proper physical condition to participate in such Activity. I HEREBY RELEASEhereby release, DISCHARGEdischarge, AGREE AND PROMISE NOT TO SUEcovenant not to sue, AND AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS EACH OF THE RELEASE'S FROM and agree to indemnify and save and hold harmless each of the Releasee’s from ALL LIABILITY CLAIMSliability, DEMANDSclaims, LOSSESdemands, OR DAMAGES ON THE MINOR’S ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE losses, or damages on the Minor’s account caused or alleged to be caused in whole or in part by the negligence of the "RELEASESReleasees" OR OTHERWISEor otherwise, INCLUDING NEGLIGENT MEDICAL ASSISTANCE OR RESCUE OPERATION AND FURTHER AGREE THAT IFincluding negligent rescue operation and further agree that if, DESPITE THIS RELEASEdespite this release, I, the Minor, or anyone on the Minor’s behalf makes a claim against any of the Releasees named above, I will indemnify, save, and hold harmless each of the Releasees from any litigation expenses, attorney fees, loss liability, damage, or cost any may incur as the result of any such claim. I GRANT TO VALE SPORTS CLUB, AND ITS SUCCESSORS AND ASSIGNS, THE IRREVOCABLE, PERPETUAL, ROYALTY FREE, WORLDWIDE, SUBLICENSABLE AND UNRESTRICTED RIGHT TO USE AND PUBLISH MINOR’S OR MY NAME, VOICE, LIKENESS, OR ANYONE ON THE XXXXX’S BEHALF MAKES A CLAIM AGAINST IMAGE; ANY PHOTOGRAPHS OF THE RELEASES NAMED ABOVEMINOR OR ME; OR ANY MATERIALS IN WHICH MINOR OR I MAY BE INCLUDED, I WILL INDEMNIFYFOR EDITORIAL, SAVETRADE, ADVERTISING, AND HOLD HARMLESS EACH OF THE RELEASES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE, OTHER PURPOSE AND IN ANY MANNER AND MEDIUM; and to alter and composite the same WITHOUT RESTRICTION AND WITHOUT MY INSPECTION OR COST ANY MAY INCUR AS THE RESULT OF ANY SUCH CLAIMAPPROVAL. I acknowledge hereby release VALE SPORTS CLUB from all claims and liability relating to any of the contagious nature of communicable diseasesforegoing, in particular the COVID 19 Coronavirus and that the United States Center for Disease Control (CDC) and many other public health authorities still recommend practicing social distancing. I further understand that Upper Southampton Academy, Inc., DBA Bucks Futsal has put in place recommended preventative measures that are intended to reduce the spread of communicable diseases including but not limited to COVID 19any claims based on rights of privacy or publicity. I further understand that Upper Southampton Academy, Inc., DBA Bucks Futsal CAN NOT guarantee that I will not become infected with communicable diseases. I understand that the risk of becoming exposed to and/or infected by communicable diseases may result from the actions, inadvertence, omissions, or negligence of myself and others, including, but not limited to, staff, guests and other clients and their families. I voluntarily seek services provided by Upper Southampton Academy, Inc., DBA Bucks Futsal, and acknowledge that I could be increasing my risk to exposure to communicable diseases including but not limited to COVID 19. I understand that I must comply with all required procedures that are intended to reduce the spread diseases while I am attending Upper Southampton Academy, Inc., DBA Bucks Futsal. I promise at all times that I am on the Upper Southampton Academy, Inc., DBA Bucks Futsal facility premises, the following will be trueSigned: * I am not experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell. * I have not traveled internationally within the last 20 days. * I have not traveled to a highly impacted area within the United States of America in the last 14 days. * I do not believe I have been exposed to someone with a suspected and/or confirmed case of any communicable diseases including but not limited to COVID 19. * I have not been diagnosed with any communicable diseases, or I have been cleared as noncontagious by state or local public health authorities. * I am following all Center for Disease Control recommended guidelines as much as possible pertaining to Coronavirus and I am limiting my exposure to communicable diseases, in particular but not limited to COVID 19. I hereby release and agree to hold Upper Southampton Academy, Inc., DBA Bucks Futsal harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act of Upper Southampton Academy, Inc., DBA Bucks Futsal or that may otherwise arise in any way in connection with any services received from Upper Southampton Academy, Inc., DBA Bucks Futsal. I understand that this release discharges Upper Southampton Academy, Inc., DBA Bucks Futsal from any liability or claim that I, my heirs, or any personal representatives may have against Upper Southampton Academy, Inc., DBA Bucks Futsal with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any services received from Upper Southampton Academy, Inc., DBA Bucks Futsal. This liability waiver and release extends to the facility together with all owners, partners, employees, and associates. By signing below, I agree to all terms stated in this agreement document above without exception. PLAYER NAME PRINTED_ _ _ _ _ _ _ _ _ _ __ Date: PARENT/GUARDIAN NAME PRINTED: PLAYER SIGNATURE: PARENT/GUARDIAN SIGNATURE:_
Appears in 1 contract
Samples: valesc.com
MINOR RELEASE. AND And I, THE MINOR’S PARENT AND/OR LEGAL GUARDIANthe minor’s parent and/or legal guardian, UNDERSTAND THE NATURE OF BUCKS FUTSAL ACTIVITIES AND THE MINOR’S EXPERIENCE AND CAPABILITIESunderstand the nature of activity and the minor’s experience and capabilities and believe the minor to be qualified, AND I BELIEVE THE MINOR TO BE QUALIFIEDin good health, IN GOOD HEALTH, AND IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN SUCH ACTIVITYand in proper physical condition to participate in such activity. I HEREBY RELEASEhereby release, DISCHARGEdischarge, AGREE AND PROMISE NOT TO SUEcovenant not to xxx, AND AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS EACH OF THE RELEASE'S FROM ALL LIABILITY CLAIMSand agree to indemnify and save and hold harmless each of the releasee’s from all liability claims, DEMANDSdemands, LOSSESlosses, OR DAMAGES ON THE MINOR’S ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE or damages on the minor’s account caused or alleged to be caused in whole or in part by the negligence of the "RELEASESreleasees" OR OTHERWISEor otherwise, INCLUDING NEGLIGENT MEDICAL ASSISTANCE OR RESCUE OPERATION AND FURTHER AGREE THAT IFincluding negligent rescue operation and further agree that if, DESPITE THIS RELEASEdespite this release, I, THE MINORthe minor, OR ANYONE ON THE XXXXX’S BEHALF MAKES A CLAIM AGAINST ANY OF THE RELEASES NAMED ABOVEor anyone on the minor’s behalf makes a claim against any of the releasees named above, I WILL INDEMNIFYwill indemnity, SAVEsave, and hold harmless each of the releasees from any litigation expenses, attorney fees, loss liability, damage, or cost any may incur as the result of any such claim. PHOTO/VIDEO RELEASE Parent, or the minor’s guardian, and/or I have read and agree to the forgoing provisions. The Edge reserves the right to use photographs, negatives, reproductions and video tapes from events held at, or in conjunction with, the facility for display, publication, marketing, advertising and other purposes without the need to compensate me or my minor or without additional approval. Negatives and videotape will be the exclusive property of The Edge. I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND HOLD HARMLESS EACH OF THE RELEASES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE, HAVE SIGNED IT FREELY AND WITHOUT INDUCEMENT OR COST ANY MAY INCUR AS THE RESULT ASSURANCE OF ANY SUCH CLAIMNATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT. Team Name / Program: Printed Name of Participant: Date of Birth: Address: City: State: Zip: Home Phone: Cell: Email: Participants Signature (only if age 18 or older): Date: Printed Name of Parent/Guardian: Date: Parent/Guardian Signature (only if participant is under the age of 18): REFUND POLICY Requests for refunds must be made in writing (mail, fax, email) and received by The Edge prior to the starting date of the event scheduled. There will be no refunds given after the start of the event. The Edge may, in its sole discretion, provide a refund or credit toward future The Edge Sports programs. A $25 processing fee will be charged to ALL refunds. Any credits will not be charged a processing fee. A full refund will be given for all programs or events cancelled by The Edge (no written request is required) EXCEPT for any acts beyond the reasonable control of The Edge, including, without limitation, any acts of GOD. Credit card refunds, if approved, will be processed within one week of the request. Cash and check refunds, if approved, will be processed within four weeks of the request. All returned checks and declined credit cards will be subject to a $25 handling charge. Note for facility agreements: Only customers, engaged in team training conducted by The Edge, who sign a facility agreement form may request a refund, based on the above policy. Destiny Holdings LLC DBA The Edge Coronavirus Waiver Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19. The coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to- person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people. Destiny Holdings LLC DBA The Edge “The Edge” - has put in place preventative measures to reduce the spread of COVID- 19 but The Edge cannot guarantee that you or your child(ren) will not become infected with COVID-19. Attendance at any The Edge programming could increase your risk and your child(ren)’s risk of contracting COVID-19. By signing this agreement, I acknowledge the contagious nature of communicable diseases, in particular COVID-19 and voluntarily assume the COVID 19 Coronavirus risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending The Edge programming and that the United States Center for Disease Control (CDC) such exposure or infection may result in personal injury, illness, permanent disability, and many other public health authorities still recommend practicing social distancing. I further understand that Upper Southampton Academy, Inc., DBA Bucks Futsal has put in place recommended preventative measures that are intended to reduce the spread of communicable diseases including but not limited to COVID 19. I further understand that Upper Southampton Academy, Inc., DBA Bucks Futsal CAN NOT guarantee that I will not become infected with communicable diseasesdeath. I understand that the risk of becoming exposed to and/or or infected by communicable diseases COVID-19 at any The Edge programming may result from the actions, inadvertence, omissions, or negligence of myself and others, including, but not limited to, staffThe Edge employees, guests volunteers, and other clients program participants and their families. I voluntarily seek services provided by Upper Southampton Academyagree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself, Inc.including, DBA Bucks Futsal, and acknowledge that I could be increasing my risk to exposure to communicable diseases including but not limited to, personal injury, disability, death, illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance at any The Edge programming ("Claims"). On my behalf, and on behalf of my children, I hereby release, covenant not to COVID 19xxx, discharge, and hold harmless The Edge, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand that I must comply with all required procedures that are intended to reduce the spread diseases while I am attending Upper Southampton Academy, Inc., DBA Bucks Futsal. I promise at all times that I am on the Upper Southampton Academy, Inc., DBA Bucks Futsal facility premises, the following will be true: * I am not experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell. * I have not traveled internationally within the last 20 days. * I have not traveled to a highly impacted area within the United States of America in the last 14 days. * I do not believe I have been exposed to someone with a suspected and/or confirmed case of any communicable diseases including but not limited to COVID 19. * I have not been diagnosed with any communicable diseases, or I have been cleared as noncontagious by state or local public health authorities. * I am following all Center for Disease Control recommended guidelines as much as possible pertaining to Coronavirus and I am limiting my exposure to communicable diseases, in particular but not limited to COVID 19. I hereby release and agree to hold Upper Southampton Academy, Inc., DBA Bucks Futsal harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act of Upper Southampton Academy, Inc., DBA Bucks Futsal or that may otherwise arise in any way in connection with any services received from Upper Southampton Academy, Inc., DBA Bucks Futsal. I understand that this release discharges Upper Southampton Academyincludes any Claims based on the actions, Inc., DBA Bucks Futsal from any liability or claim that I, my heirsomissions, or any personal representatives may have against Upper Southampton Academynegligence of Destiny Holdings LLC DBA The Edge, Inc.its employees, DBA Bucks Futsal with respect to any bodily injuryagents, illnessand representatives, deathwhether a COVID-19 infection occurs before, medical treatmentduring, or property damage that may arise fromafter participation in any The Edge programs. I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND HAVE SIGNED IT FREELY AND WITHOUT INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT. Name of Parent or in connection to, any services received from Upper Southampton Academy, Inc., DBA Bucks Futsal. This liability waiver and release extends to the facility together with all owners, partners, employees, and associates. By signing below, I agree to all terms stated in this agreement document above without exception. PLAYER NAME PRINTED: PARENT/GUARDIAN NAME PRINTED: PLAYER SIGNATURE: PARENT/GUARDIAN SIGNATURECustodial Adult Signing Agreement:
Appears in 1 contract
Samples: Consent and Photo Release Agreement