I acknowledge that volleyball or any sporting event is an extreme test of a person’s physical and mental limits and carries with it the potential for death, serious injury, or property loss.  I HEREBY ASSUME THE RISKS OF PARTICIPATING OR OFFICIATING IN A VOLLEYBALL EVENT.

 

I hereby take the following action for myself, my executors, administrators, heirs, next of kin, successors and assigns: a) I waive, release, and discharge from any and all claims or liabilities for death or personal injury or damages of any kind, except that which is the result of gross negligence and/or wanton misconduct of persons or entities listed below, which arise out of or relate to my participation in, or my traveling to and from the volleyball event, the following persons or entities: Lakeview Community Schools, any school or organization hosting any competition related to the Heartland Winter League, tournament directors and/or sponsors, tournament organizers, and tournament volunteers; b) I agree not to sue any of the persons or entities mentioned above for any of the claims or liabilities that I have waived, released, or discharged herein: and c) I indemnify and hold harmless the persons or entities mentioned above from any claims made or liabilities assessed against them as a result of my actions.

 

By signing this form, I affirm that I have read this document and understand its contents.

 

Parents must sign for minors, under the age of 18.  Please print the athlete’s name and then sign your name beside theirs.

 

YOUTH NAME                                             PARENT SIGNATURE

 

___________________________           ________________________________

 

 

Signed this _____________ day of ________________, 20__.

 

 

TEAM NAME - _________________________________________