Release
of Liability Agreement
NOTE: PARTICIPANTS MUST READ THIS FORM
CAREFULLY!
|
ALL PLAYERS UNDER THE AGE OF 18 AT SAID TIME OF PARTICIPATION MUST HAVE A
PARENT OR LEGAL GUARDIAN SIGN BELOW. |
In
consideration of being permitted in any way in a sport and activities of
Volleyball under the auspices of LUCKY 66 BOWL INC. (Lucky 66 Volleyball), I
acknowledge, appreciate and agree that:
The possibility of injury from the activity involved in Volleyball is significant, including illness but not limited to bodily injury, disease, strains, fractures, partial and/or total paralysis, eye injury, blindness, heat stroke, heart attack, the potential of permanent disability, death, or other ailments that could cause serious disability. The risk of serious injury does exist. I understand and agree that the Volleyball field structure is for containment of Volleyballs only.
I understand and agree that any netting, poles, fencing, cable or any other parts of the structure is not to be climbed on, jumped on, run into, or used to support anything other than what it is designed for, containment.
I KNOWINGLY AND FREELY ASSUME ALL SUCH RISK, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE of those persons released from liability below, and assume full responsibility for my participation.
I understand that the activities of Volleyball are physically and mentally intense. I understand the rules of play and will comply with all rules and regulations. If I observe any unusual or unnecessary hazard during my participation, I will bring such to the attention of the nearest official as soon as practical.
I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS LUCKY 66 Bowl Inc. (Lucky 66 Volleyball), the owners and lesser of premises used to conduct the volleyball activities, their officers, officials, agents and/or employees (“Releasees”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER CAUSED BY NEGLIGENCE OF RELEASEES OR OTHERWISE, except that which is the result of gross negligence and/or wanton misconduct.
Said release shall further assign LUCKY 66 BOWL INC. (Lucky 66 Volleyball), all rights to use any photos or video of me taken relative to playing the game.
I HAVE READ AND UNDERSTAND THIS AGREEMENT, AND I AM AWARE THAT BY SIGNING THIS AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS AND ASSIGNS MAY HAVE AGAINST THE RELEASEES.
Participant’s Name (print neatly) ______________________________
Date of Birth ______________
Age in Years ____
Email _______________________________________
Street Address ____________________________________
City ____________________
State ___
Zip Code ______
Phone Number ______________
Driver License #_____________
Other form Of ID ________________State___
Expires__________
Participant’s Signature ______________________
Date Signed __________
ALL PLAYERS UNDER THE AGE OF 18 AT SAID TIME OF
PARTICIPATION MUST HAVE A PARENT OR LEGAL GUARDIAN SIGN BELOW.
I certify that I am the parent or guardian with legal
responsibility for the above signed participant and agree to his/her
participation in Volleyball activities and competition. I agree to the Release
of Liability and its conditions for my heirs, assigns, next of kin and myself.
Parent/Guardian Signature____________________
Date Signed
_________
Driver License #__________________
State___
Expires_______
Other form of ID ____________________