In consideration of the use of the property, facilities and/or services of the Vineland Soccer Association or any AUXILIARY ORGANIZATIONS (Auxiliaries) participating or sponsoring Recreational Sports Programs, including travel related thereto, the undersigned agrees as follows:
RISK FACTORS: The undersigned understands and
acknowledges that the use of equipment, facilities and services provided by
the Vineland Soccer Association (intramural) involves risks such as, but not
limited to, the following which might result from the use of equipment or
facilities, from the activity itself, from the acts of others, or from the
unavailability of emergency or emergency medical care. RISK OF
PROPERTY DAMAGE, BODILY INJURY, AND POSSIBLE DEATH.
ASSUMPTION OF RISK. The undersigned ASSUMES ALL
RISKS THAT ARISE OUT OF THE USE OF THE EQUIPMENT OR FACILITIES, THE ACTIVITY
ITSELF, THE ACT OF OTHERS, OR THE UNAVAILABILITY OF EMERGENCY CARE,
including but not limited to, those RISK FACTORS described in section 1
above.
ACKNOWLEDGMENT OF POLICIES AND PROCEDURES. The
undersigned acknowledges reading and knowing all of the policies and
procedures relating to the activities, facilities, and/or equipment and
understands that the safe and proper use of the facilities, equipment or
participation in the activity is dependent upon carefully following such
policies and procedures.
PREREQUISITE SKILLS AND TRAINING. The
undersigned acknowledges that he or she has the requisite skills,
qualifications, physical abilities, and training necessary for proper and safe
use of the equipment and facilities and to participate in the activity
itself. The undersigned agrees that if he or she has any questions as to
what skills, qualifications or training is necessary to properly use the
equipment, facility, or to participate in the activity itself, then they shall
direct such questions to the appropriate staff member on
site.
RELEASE. The undersigned RELEASES the City
of Vineland, Members of Vineland Soccer Association Board of Directors,
the organizing body of the Adult Summer Soccer League, and Any Participating Players, and any
agents of each and agrees NOT TO SUE them on account of or in
conjunction with any claims, causes of action, injuries, damage, cost of
expenses arising out of the activity, including those based on death, bodily
injury or property damage whether or not caused by the acts, omissions or
other fault of the parties being released.
WAIVER. The undersigned waives the protection
afforded by any statute or law in any jurisdiction whose purpose, substance,
and/or effect is to provide that a general release shall not extend to claims,
material or otherwise which the person giving the release does not know of or
suspect at the time of executing the release. This means, in part, that
the undersigned is releasing unknown future claims.
INDEMNIFY AND DEFEND. The undersigned agrees to
INDEMNIFY AND DEFEND the City of Vineland, Board Members of Vineland
Soccer Association, the organizing body of the Adult Summer Soccer League, the Participating Players, and any agents of each of each
against, and hold them harmless from any or all claims, causes of action,
damage judgments, costs or expenses, including attorney fees which in any way
arise from the activity or this agreement which include but are not limited to
damages to or destruction of any property of the indemnitee, of any others,
injury or death of the undersigned or anyone else or any liability arising
from the act or negligent act of the indemnitee, the undersigned or anyone
else.
PAY. The undersigned agrees to pay for any or all
damages to any property or indemnities caused by the undersigned either
negligently, willfully, or otherwise.
REPRESENTATIVES. The undersigned enters into this
agreement for himself/herself, his/her heirs, assigns and legal
representatives.
EMERGENCY TREATMENT CONSENT. The undersigned, as a
participant in the subject activity, hereby consents to medical treatment in a
medical emergency where the undersigned is unable to consent to such
treatment.
INSURANCE. The undersigned understands that the
Vineland Soccer Association and its auxiliaries do not carry participant
insurance. The undersigned is encouraged to have a physical examination
and to purchase health insurance prior to any and all
participation.
ACKNOWLEDGMENT. The undersigned is over the age of 18, has read and understands this agreement and realizes it relates to surrendering valuable legal rights and does so freely and voluntarily.
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Name:_____________________________________________________
Signature: Date:
Staff Initials:
EMERGENCY CONTACT INFORMATION:
NAME
ADDRESS
CITY STATE ZIP TELEPHONE