Howell PAL

 Howell PAL Participant Waiver

NOTE: THIS FORM MUST BE READ AND SIGNED BEFORE THE MEMBER IS ALLOWED TO TAKE PART IN ANY TRAINING, COMPETITION, MEETING OR TESTING SESSIONS. BY SIGNING THIS FORM, THE PARTICIPANT AND/OR PARENT OR GUARDIAN AGREES THAT THEY HAVE READ THIS WAIVER.

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Program Name: _________________________________________________

Member’s Name: ________________________________________________

Address: _______________________________________________________

Phone: _____________________________________Date of Birth: ______/_____ /______

IN CONSIDERATION of my involvement in the sport and activities under the auspices of the Howell PAL , Howell Police Activities League, their officers, volunteers, staff, sponsors, and/or agents acknowledge, appreciate and agree that:

1.         I RISK BODILY INJURY, INCLUDING PARALYSIS, DISMEMBERMENT and DEATH, while the particular rules of my sport, equipment, and personal training and discipline may reduce this risk, THE RISK OF INJURY DOES EXIST, AS DOES THE RISK OF DAMAGE TO OR LOSS OF PROPERTY.

2.         I KNOWINGLY AND FREELY ASSUME ALL RISKS, BOTH KNOWN AND UNKNOWN, EVEN IF ARISING FROM NEGLIGENCE OF THE ABOVE MENTIONED RELEASED PARTIES.

3.         I willingly agree to comply with the stated and customary terms and conditions for participants, if however I observe any unusual or unnecessary hazard during my presence or participation, I will bring these incidents to the immediate attention of the nearest official/coach.

4.         FOR MYSELF, AND ON BEHALF OF MY HEIRS, THOSE ASSIGNED AS A PERSONAL REPRESENTATIVE, AND NEXT OF KIN, HEREBY: RELEASE, HOLD HARMLESS AND PROMISE NOT TO SUE HOWELL PAL, HOWELL POLICE ACTIVITIES LEAGUE, OR THEIR OFFICERS, VOLUNTEERS, STAFF, OR SPONSORS. FURTHER I AND/OR MY PARENT/GUARDIAN “RELEASES” LIABILITY OF ANY OF THE FORE MENTIONED TO ANY AND ALL INJURY AND LOSS ARISING FROM MY PARTICIPATION, WHETHER CAUSED BY NEGLIGENCE OR OTHERWISE, EXCEPT THAT WHICH IS THE RESULT OF GROSS NEGLIGENCE OR WANTON MISCONDUCT.

5.         I grant to Howell PAL, its representatives and employees the right to take photographs of my child in connection with the above-identified subject.  I authorize Howell PAL, its assigns and transferees to copyright, use and publish the same in print and/or electronically.

I agree that Howell PAL may use such photographs of my child with or without their name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.

I have read this Release of Liability and Waiver of Agreement and fully understand its terms and sign it freely and voluntarily.

This signature is to certify that I, as a parent/guardian with legal responsibility for this participant, consent to the above mentioned and agree to his/her release, and also agree for myself/ourselves, my/our heirs, assigns and next of kin, to release and identify from all liability, incidents to my/our child’s involvement as stated above.

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Parent/Guardian Signature                                                                                                                                Date Signed

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 Member Signature                                                                                                                                              Date Signed