WAIVER, RELEASE, AND CONSENT TO MEDICAL ATTENTION
In exchange for my being
allowed to participate as a volunteer in the RHI Sports Program (“Program”), I,
and if I am not 18 years, old my parent or legal guardian, agree to be bound by
each of the following:
1.
Identification of Risks. I understand that
participation in the Program may involve risk of injury, disability or death.
2.
Assumption of Risks. I assume all risks connected
with my participation in the Program. I accept personal responsibility of
any liability, injury, loss or damage in any way connected with my
participation in the Program, and while
3.
particular
skills, equipment, and personal discipline may reduce those risks, the risks may
continue to exist.
4.
Waiver and Release. I release and discharge RHI and
Program and the Town of Cicero, and each of their affiliated organizations,
directors, officers, sponsors, employees, agents, successors, and assigns,
clubs, host organizations, referees, coaches, volunteers, club members,
individual members, contractors, participants,
advertisers, and, if applicable, owners or lessors of premises used for
the activity, (“THE
RELEASEES”} from all claims for any liability, injury,
loss, damage, or causes in any way connected with my participation in the
Program, to the fullest extent permitted by law.
5.
.
I acknowledge that the Program and Town of Cicero are not liable for injury
arising out of participation in the activities, even if arising from or caused
by the ordinary negligence or otherwise of THE RELEASEES.
6.
I intend for this waiver and release to also
apply to my relatives, personal representatives, heirs, beneficiaries, next of
kin, and assigns who might pursue and legal action or claim for such liability,
injury, loss or damage.
7.
Consent for Medical Treatment. I agree that
RHI and Program may, but have not duty to provide me, through medical personnel
of their choice, medical assistance, transportation, and emergency medical
services, from any licensed physician, athletic trainer, hospital or clinic
8.
Hold Harmless. I agree to indemnify and hold harmless RHI
and Program, and the Town of Cicero for all claims arising out of my
participation in the activities.
9.
Health and Lack of Impairment. I, or my
parent/legal guardian, represent that, to my/their knowledge, I am in good
health and suffer no physical impairment that would or should prevent my
participation in volunteer activities.
10. Choice of Law: The
foregoing agreement, consent, waiver and release shall be governed, interpreted
and construed according to the law of the State of Indiana, without reference
to choice of law principles.
I understand this waiver is intended to be as broad
and inclusive as permitted by the laws of the state of Indiana and agree that
if any portion of the agreement is invalid, the remainder will continue in full
legal force and effect.
FOR PARTICIPANTS UNDER THE AGE OF 18 OR LEGALLY INCAPACITATED
Undersigned parent, or legal guardian, or legal representative acknowledges that he/she is not only signing this Agreement on his/her/their behalf, but that he/she/they is also signing on behalf of the minor or legally incapacitated adult and that the minor or the legally incapacitated adult shall be bound by all the terms of this Agreement. Additionally, by signing this Agreement as the parent, or legal guardian, or legal representative of a minor or legally incapacitated adult, the parent, legal guardian, or legal representative understands that he/she/they is also waiving rights on behalf of the minor or legally incapacitated adult that the minor or legally incapacitated adult otherwise may have. The Undersigned parent, or legal guardian, or legal representative agrees that, but for the foregoing, the minor or legally incapacitated adult would not be permitted to participate in the activities. By signing below, I hereby represent that I am the parent, legal guardian, or legal representative of a minor, or legally incapacitated adult Participant and that I have the authority to sign on the Participant’s behalf.
I HAVE READ THIS WAIVER, RELEASE OF
LIABILITY, AND CONSENT AND FULLY UNDERSTAND AND AGREE TO THE TERMS AND
CONDITIONS CONTAINED HEREIN, AND UNDERSTAND THAT I HAVE
GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT.
I AM SIGNING THIS WAIVER, RELEASE, AND CONSENT FREELY AND VOLUNTARILY.