Henley Elite Athlete Training Wavier

Registering for Pottsgrove Football - 05/14/2019 12:00 AM - 08/02/2019 12:00 AM

Waiver & Release of Liability:

In consideration of being allowed to participate in any way in the Henley Elite Athlete Training LLC programs or rentals, the undersigned acknowledges, appreciates and agrees that:

I. The risk of injury from the activities involved in this program is significant, including the potential for paralysis and death, and while particular rules, equipment, and personal discipline may reduce risk, the risk of serious injury does exist; and

II. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the Releasees or others, and assume full responsibility for my voluntary participation; and

III. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any usual or unusual significant hazard during my presence or participation, I will remove myself or the child I am a guardian over from participating and bring such to the attention of the nearest staff member immediately; and

IV. I, for myself and on behalf of my spouse, heirs, assigns, personal representatives and next of kin, hereby release and hold harmless, Henley Elite Athlete Training LLC, the host organization and facility, any owners, sponsors, coaches, officials, volunteers, employees, agents, officers or directors of the above organization, and if applicable, owners and lessors of premises used to conduct the event (collectively the “Releasees”) with respect to any and all injuries, disabilities, loss of life or damage to person or property occurring or arising out of participation in the program. I have read this release of liability and assumption of risk agreement, fully understand its terms, understand that I have given up substantial rights by signing it, and sign it freely and voluntarily without any inducement. If participant is under the age of 18, this certifies that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releases, and for myself, my spouse, my heirs, assigns, and next of kin, I forever realize and agree to indemnify, defend and hold harmless the Releases form from any and all liabilities as set forth above arising of or occurring from my or my minor child’s involvement or participation in Henley Elite Athlete Training LLC programs organized or sponsored or run by any of the Releasees, owners, their agents or representatives.

Initial Here


Waiver & Release of Liability - Basketball Court or other rooms use:

In consideration of being allowed to participate in any of the programs, activities, and events that Ugana,
LLC dba Pottstown Integrated Wellness Complex (hereafter referred to as “Facility”) offers, the
undersigned acknowledges, appreciates, and agrees that:

The Participant/Parent for itself or its child understands that all activities of Facility include inherent risks
that cannot be totally eliminated regardless of the care taken by the Facility. The Participant/Parent
acknowledges, understands, and appreciates the types of injuries inherent in the Facility’s activities, and
hereby knowingly assumes all inherent risks of such activities. Furthermore, the Participant/Parent, on
behalf of itself, its spouse, heirs, personal representatives, and assigns (collectively “Releasing Parties”)
does hereby knowingly and voluntarily, fully and forever, waive, release, discharge and covenant not to
sue the Facility for alleged liability from any and all claims arising from the ordinary negligence of the
Facility and any of its current and former principals, directors, officers, employees, agents and
representatives (“Protected Parties”).

This agreement applies to personal injury, including death, from the incidents or illnesses arising from
participation in the Facility’s activities including, but not limited to recreational, practice, or competitive
activity; events; organized or individual training and conditioning activities; tests; classes and instruction;
individual use of facilities, equipment, locker room areas, and all premises, or attendance at such
activities whether or not as a participant, including the associated sidewalks and parking lots, and to any
and all claims resulting from the damage to, loss of, or theft of property (the inclusive activities).
The Participant/Parent also agrees to hold harmless, defend, and indemnify the Facility that is, defend
and pay any costs, including damages awarded, investigation costs, reasonable attorney’s fees, and
related expenses from any and all claims arising from the Participant/Parent’s or its child’s participation in the activities at the Facility. The Participant/Parent further agrees to hold harmless, defend, and
indemnify the Facility against any and all claims of co-participants, rescuers, and others arising from the
conduct of the Participant/Parent or its child in such activities.

The Participant/Parent, certifies that: (i) the Participant/Parent is at least 18 years of age or has reached
the age of majority in the jurisdiction in which it lives or resides and (ii) it is, or its child is, in good physical condition and can participate in sports and related activities, and further agrees and warrants that at any time the Participant/Parent believes conditions to be unsafe, the Participant/Parent will immediately discontinue further participation for itself or its child in the activity.

The Participant/Parent confirms that this waiver supersedes any and all previous oral or written promises
or agreements relating to the subject matter herein. The Participant/Parent understands that this is the
entire agreement between the Facility and itself regarding waiver and acceptance of risk, and cannot be
modified or changed in any way by representations or statements by any agent or employee of the
Facility. The Participant/Parent understands the foregoing assumption of risk, waiver of liability, and
indemnification agreement is intended to be as broad and inclusive as permitted by the laws of the State
of Pennsylvania, and that if any portion thereof is held invalid, it is agreed that the balance shall,
notwithstanding, continue in full legal force and effect, and if legal action is brought, the appropriate trial
court for the County of Montgomery, in the State of Pennsylvania, has the sole and exclusive jurisdiction
and that only the substantive laws of the State of Pennsylvania, shall apply.

The Participant/Parent acknowledges that it has read and understands this agreement. The
Participant/Parent acknowledges and understands that it is giving up substantial rights, including the
rights of its child to sue for damages in the event of death, injury, or loss. The Participant/Parent
acknowledges that it is voluntarily agreeing to these terms, conditions, waivers and releases and intends
this agreement to be a complete release of all liability, including that due to ordinary negligence by the
Protected Parties, to the greatest extent allowed by the laws of the State of Pennsylvania.
Finally, the Participant/Parent takes full responsibility for knowing and abiding by the rules of the Facility
and understands and acknowledges that if it does abide by the rules of the Facility, it risks being banned
from the facility and having all of its money forfeited.

Initial Here


Photo and Media Release:

The participants, which shall include the undersigned parent/guardian if participant is under the age of eighteen (18), (“Participant”), hereby grants Henley Elite Athlete Training LLC, its affiliated entities, independent contractors, franchisees, licensees, legal representatives and assigns, and third parties acting on behalf of any of the foregoing, (collectively, “the Henley Elite Athlete Training Parties”) an irrevocable, royalty-free license to use Participant’s name, photograph, voice, likeness and any identifiable attributes, in whole or in part, in connection with any materials created by the Henley Elite Athlete Training Parties, or third parties on behalf of the Henley Elite Athlete Training Parties, in any media (the “Images”) without inspection or approval of the finished product or use to which it may be applied.  Henley Elite Athlete Training shall be the exclusive owner of the Images and all rights, including copyrights, in the Images. 

Participant further waives, releases and holds harmless the Henley Elite Athlete Training LLC Parties from any and all claims and liability associated with this license and/or the Images including, without limitation, anything Participant might deem a misrepresentation by virtue of alterations, optical illusion or faulty mechanical reproduction.  Participant understands and agrees that no payment will be made to Participant for the use of the Images and nothing herein creates an obligation on the part of any of the Henley Elite Athlete Training Parties to make any use of Participant’s name, photograph, voice, likeness or any identifiable attributes, in whole or in part.

Participant grants Henley Elite Athlete Training LLC the right to post images, reference name(s), voice, and any identifiable attribute on social media including but not limited to: Instagram, Facebook, Twitter, Snapchat, etc. Participant understands that they may make a written request to not appear on Henley Elite Athlete Training’s social media pages in which Henley Elite Athlete Training will do their best to respect that request.

Participant is eighteen (18) years of age or older, has read this Release and Agreement prior to its execution and has full capacity to execute it, and will not seek to disaffirm this Release and Agreement.  If Participant is under eighteen (18) years of age, the parent/guardian below has read this Release and Agreement prior to its execution and has full capacity to execute it, and Participant and parent/guardian will not seek to disaffirm this Release and Agreement.

Initial Here

Who will be participating?

Adult  Adult and Children  Children

Parent / Guardian Information

* Optional:

Create a password to save time and auto-fill your information on your next visit!

Sign Here

By clicking 'I Agree' below, you agree that you have read and agree with the terms of the waiver and that the information you provided is accurate. You furthermore agree that your submission of this form, via the 'I Agree' button, shall constitute the execution of this document in exactly the same manner as if you had signed, by hand, a paper version of this agreement.