SWIFFERS TRACK CLUB Athletic / Waiver

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SWIFFERS TRACK CLUB Athletic/Waiver

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SWIFFERS TRACK CLUB Athletic / Waiver / Release Form In consideration of being permitted to
participate in any way with any SWIFFERS TRACK CLUB practice(s) and/or meet(s), I/we the
undersigned:
1. Agrees and represents that I/WE understand the nature of track and field and that my son/daughter or
I am qualified, in good health, and proper physical condition to participate. I also agree that if at any time
I believe conditions or THEIR/MY health to be unsafe, I will discontinue THEIR/MY further participation in
the meet or practice.
2. Fully understand that athletic activities involve risks of serious injury, permanent disability, paralysis,
and death and social losses which might result not only from their actions or negligence, but the actions
or negligence of others, the rules of play, or the condition of the meet site or any of the equipment used.
There may be other risks not known or foreseeable at this time.
3. 3. Agree that the parents or a legal guardianwill inspect the facilities and equipment to insure
proper safety for the minor participants. If anything is believed to be unsafe, a coach/parent or official
should be notified immediately of such conditions and the participant will refuse to participate.
4. 4. Each participant is to be properly insured and/or pay all medical costs in the event of an injury
and in the case of emergency must provide a contact person for each minor
participant. Furthermore, assume all risks and accept personal responsibility for damages on account of
injury, death or damage to property, caused or alleged to be caused in whole or in part by the negligence
of the release.
5. 5. Release, waive, and agree not to sue SWIFFERS TRACK CLUB meet directors, staff or
volunteers of the organizations, if applicable, owners and leasers of the meet sites, which are all
released from demands, losses or damages on account of injury, death or damage to property, caused
or alleged to be caused in whole or in part by the negligence of the release.
6. On behalf of the Minor, I hereby Release, Waive and Covenant Not to Sue, and further agree to
Indemnify, Defend and Hold Harmless the following parties: SWIFFERS TRACK CLUB, USA Track &
Field, Inc., its Associations and Committees, EVENT ORGANIZER NAME, Inc., Event Directors and
Promoters, Sponsors, Advertisers, Coaches and Officials; Venue and Property Owners upon which the
Event takes place; Law Enforcement Agencies and other Public Entities providing support for the Event;
and each of their respective parent, subsidiary and affiliated companies, officers, directors, partners,
shareholders, members, agents, employees and volunteers (Individually and Collectively, the “Released
Parties” or “Event Organizers”), with respect to any liability, claim(s), demand(s), cause(s) of action,
damage(s), loss or expense (including court costs and reasonable attorney’s fees) of any kind or nature
(“Liability”) which may arise out of, result from, or relate in any way to the Minor’s participation in the
Event, 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, I, the Minor, or anyone on the Minor’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 any may be incurred as the result
of such claim. I hereby warrant that I am of legal age and authorized to enter into this Agreement on
behalf of the Minor, that I have read this Agreement
7. 7. If injury or illness occurs while competing in the meet or practice, I authorize emergency first
aid, medical treatment, medication or surgery necessary by medical personnel.
8. 8. I give my permission for the participants listed below to be used in any promotions. This
includes pictures, interviews, television, and radio or film coverage during events without compensation
to me.
9. 9. This waiver / agreement shall be binding upon the heirs, executors, and assigns of all the
undersigned.
10. I have read and fully understand all forms, rules, procedures and policy dealing SWIFFERS
TRACK CLUB.
MINOR #1: Print Name: _________________________________________ Age: ______ Date of Birth:
______/______/_______ Male Female
MINOR #2: Print Name: _________________________________________ Age: ______ Date of Birth:
______/______/_______ Male Female

MINOR #3: Print Name: _________________________________________ Age: ______ Date of Birth:
______/______/_______ Male Female
X _____________________________________________________ _______/_______/____________

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SWIFFERS TRACK CLUB Athletic/Waiver

1 file(s) 29.64 KB

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