PLEASE READ CAREFULLY AND SIGN BELOW TO INDICATE YOUR AGREEMENT.
NOTE: THIS FORM INCLUDES A RELEASE OF LIABILITY.
Please review and complete the sections below and sign in the space provided to indicate your agreement with all statements made in such sections.
AUTHORIZATION AND RELEASE OF LIABILITY
I, the parent or guardians of the above-named child, authorize the participation of my child in the Southwest Arkansas Sports and Recreation Youth Program. My child will participate in the Southwest Arkansas Sports and Recreation sport denoted on this form. I understand that this Program is a nonprofit sports program for youth and that my child’s participation is voluntary and not essential to completion of requirements of any program, school or government agency. I understand that the Program is conducted by the Nonprofit and its volunteers and staff, including parents of other participating children. I also understand that the Nonprofit is solely responsible for all aspects of the Program including selection and supervision of all persons conducting the Program. I further understand and agree that my child’s participation in athletic and other activities of the Program necessarily involves the risk of injury and even death from various causes, including but not limited to accidents, falls, strenuous and prolonged physical activity, dehydration, illness, collision or dispute with other participants, weather related injuries, playing area and equipment defects, and negligence of coaches and referees. On behalf of my child, me, and my family, I assume these risks.
In consideration of the privilege of my child’s participation in the Program, and on behalf of my child and me as parent/guardian, I hereby release, discharge, hold harmless and indemnify, and covenant not to sue, the Nonprofit, and all of the Nonprofit’s and directors, officers, employees, volunteers, insurers, agents and representatives, and all other persons associated with the Program (including without limitation any other participating churches, sponsors, parents, vendors, coaches and other game and event workers, officials, drivers, and organizations) as to any and all claims of my child, me and other family members for personal injuries suffered by my child, property damage, medical expenses, and economic loss arising directly or indirectly out of my child’s participation in the Program, and any first aid, medical care or treatment provided to my child in the event my child is injured or becomes ill while participating in Program activities, and excepting claims that may not be released under applicable law. This Release of Liability shall be as broadly construed as allowed by law to include all claims and rights that the child, that I as parent/guardian, and that other family members may have. I am a legally responsible parent or guardian of my child. If any provision of this Release of Liability is deemed invalid, the remaining provisions shall remain in full force and effect. This Release of Liability shall be binding on me, my family, heirs, next of kin, legal representatives, beneficiaries, successors and assigns. I give permission for free use of my child’s name and picture in team photos, broadcasts, telecasts or written accounts for any participation in a Southwest Arkansas Sports and Recreation sponsored event.