PA Revs All Starz Athlete Registration – Kutztown Clinic

WAIVER AND RELEASE OF LIABILITY AND AGREEMENT TO PARTICIPATE
For and in consideration of PA Revs All Starz, a Project of The Foundation for Enhancing Communities, fiscal sponsor (PA REVS), USA Field Hockey (USAFH) and Kutztown Clinic (KC) allowing the participant to participate in any camp/clinic event, including, but not limited to, athletic competitions, games, tournaments, practices, camps, clinics, tryouts, and related activities (the “Events”); I, for myself, and/or on behalf the participants’ parents/legal guardians, heirs and next of kin, and any legal and personal representatives, executors, administrators, successor and assigns, hereby agree to and make the following contractual representations pursuant to this Waiver and Release of Liability, Assumption of Risk and Indemnity Agreement (the “Agreement”);

1. I hereby represent that the participant is in good health and in proper physical condition to participate in the Events and that the participant is not under the influence of alcohol or any illicit or prescription drugs which would in any way impair the participant’s ability to safely participate in the Events. I agree that it is my sole responsibility to determine whether the participant is sufficiently fit and healthy enough to participate in the Events, and that I am responsible for the participant’s safety and well-being at all times and under all circumstances while at the Events.

2. I understand and acknowledge the risks and dangers associated with participation in the sport of field hockey, the Events and related activities, including without limitation, the potential for serious bodily injury, sickness and disease, permanent disability, paralysis and loss of life; loss of or damage to equipment/property; exposure to extreme conditions and circumstances; contact with other participants, coaches, umpires, officials, spectators, animals or other natural or manmade objects; dangers arising from adverse weather conditions; imperfect field conditions; land, water, and surface hazards; equipment failure; inadequate safety measures; participants of varying skill levels; situations beyond the immediate control of the Directors; and other undefined, not readily foreseeable and presently unknown risks and dangers (“Risks”). I understand that these Risks may be caused in whole or in part by the participant’s own actions or inactions, the actions or inactions of other participating in the Events, or the negligent acts or omissions of the Released Parties defined below, and the participant expressly assumes all such Risks and responsibility for any damages, liabilities, losses, or expenses which may be incurred as a result of participation in any of the Events.

3. I understand that the participant is required to be familiar with and abide by the Policies, Rules and Regulations of PA REVS, USAFH & KC, including but not limited to, the Competitive Rules adopted by USA Field Hockey and any safety regulations established for the benefit of all participants. The participant accepts sole responsibility for their conduct and actions while they are participating in the Events.

4. I hereby Release, Waive and Covenant Not to Sue, and further agree to Indemnify, Defend and Hold Harmless the following parties: The Foundation for Enhancing Communities (TFEC), PA REVS, USAFH & KC, their member athletes/players, coaches, umpires, trainers, Directors, sponsors, advertisers, and the host facility/venue and the property owners or operators where the Events take place (Individually and Collectively, the “Released Parties”), with respect to any liability, claim(s), demand(s), cause(s) of action, damage(s), loss or expense (including court costs and reasonable attorney fees) of any kind or nature (“Liability”) which may arise out of, result from, or relate in any way to the participant’s participation in the Events, including claims for Liability caused in whole or in part by the negligent acts or omissions of the Released Parties. I further agree that if, despite this Agreement, the participant, or anyone on the participant’s behalf, makes a claim for Liability against any of the Released Parties, I will indemnify, defend and hold harmless each of the Released Parties from any such Liabilities which may be incurred as a result of such claim.

5. I hereby certify that the participant is covered for illness and/or injury by medical insurance. If the participant is not covered by medical insurance, I agree that I am fully responsible in all respects, including, without limitation, for any financial obligations incurred out of pocket or otherwise for any medical services and/or treatments rendered for illness and/or injury suffered by the participant before, during, or after any of the Events.

6. I hereby authorize TFEC, PA REVS, USAFH & KC to use photographs or video images of participant for purposes related to promoting TFEC, PA REVS, USAFH & KC or individual players to colleges and universities, in the media, in printed materials, on the internet, and/or on social media.