By affixing my signature to this form, I, on behalf of myself, and my heirs, assigns and next of kin, hereby enter into this Waiver Agreement IN CONSIDERATION OF my being able to participate as a volunteer at practices, games or other activities (“EVENTS”) sanctioned by the El Segundo Inline Hockey Association (“ESIHA”) and to enter the premises or facilities where the EVENTS are taking place.

DISCLAIMER, ASSUMPTION OF RISK AND WAIVER: I ACKNOWLEDGE THAT PARTICIPATION IN HOCKEY NECESSARILY INVOLVES CONTACT WITH CONSIDERABLE FORCE, AND RISK OF SEVERE, PERMANENT PHYSICAL INJURY INCLUDING BRUISES, SCRAPES, STRAINED, SPRAINED OR TORN MUSCLES, TENDONS OR LIGAMENTS, BROKEN BONES, DISLOCATION OF JOINTS, CONCUSSION, BRAIN DAMAGE, NERVE AND SPINAL CORD INJURY, PARALYSIS AND DEATH. I WILLINGLY AND VOLUNTARILY ACCEPT AND ASSUME ALL SUCH RISKS, BOTH KNOWN AND UNKNOWN, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES.

I HEREBY RELEASE, DISCHARGE AND AGREE TO HOLD HARMLESS, TO THE FULLEST EXTENT PERMITTED BY LAW, ESIHA, ITS PLAYERS, EMPLOYEES, VOLUNTEERS, OFFICIALS, SPONSORS AND OTHER REPRESENTATIVES AND ALL OWNERS, LESSORS, LESSEES OR OTHER PERSONS OR ENTITIES ALLOWING THE USE OF FACILITIES BY ESIHA AND THE AGENTS, EMPLOYEES, OFFICERS AND DIRECTORS OF SAID PERSONS OR ENTITIES (“RELEASEES”) FROM ALL CLAIMS, DEMANDS, CAUSES OF ACTION, COSTS, EXPENSES AND COMPENSATION ARISING OUT OF OR IN ANY WAY RELATED TO A LOSS, INJURY OR OTHER DAMAGE TO ME OR TO MEMBERS OF MY FAMILY OR MY HOUSEHOLD OR INDIVIDUALS I INVITE OR FOR WHOM I AM OTHERWISE RESPONSIBLE, OR THEIR PROPERTY, WHILE PARTICIPATING IN OR PRESENT AT ANY OF THE EVENTS, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE. I ACKNOWLEDGE THAT ESIHA IS PRIMARILY ADMINISTERED BY VOLUNTEERS RATHER THAN PAID PROFESSIONALS. I ACKNOWLEDGE AND AGREE THAT THIS WAIVER AGREEMENT IS INTENDED TO BE AS BROAD AND INCLUSIVE AS PERMITTED BY THE LAWS OF THE STATE IN WHICH PARTICIPATION TAKES PLACE AND AGREE THAT IF ANY PORTION OF THIS WAIVER AGREEMENT IS DEEMED TO BE INVALID, THE REMAINDER WILL CONTINUE IN FULL LEGAL FORCE AND EFFECT. ACKNOWLEDGEMENT AND CONSENT.

For internal and external use, ESIHA may obtain, compile and use contact information, hockey photographs and audio visual recordings of me or my child. I consent to such uses and hereby waive all rights to approval and compensation.

I HAVE READ ALL AGREEMENTS SET FORTH HEREIN AND I FULLY UNDERSTAND THE TERMS OF EACH AND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING THIS FORM AND AGREEING TO SAID TERMS. I SIGN THIS FORM FOR MYSELFAND ON BEHALF OF MEMBERS OF MY FAMILY, AND AGREE TO THESE TERMS FREELY AND VOLUNTARILY AND WITHOUT INDUCEMENT. I ALSO AGREE TO INFORM ESIHA IN A TIMELY MANNER IF ANYTHING ON THIS FORM CHANGES.

I agree to use an electronic signature and that any physical or electronic copy of this registration form and its attachments can be used as if it was an original.

I am an adult of the age of majority in my state. I agree the terms and conditions hereof shall apply to all of my participation in the Events, regardless of the year or season in which such participation takes place, unless superseded by a new volunteer application.

 

If you prefer not to sign via digital signature, please print, sign and email this form to info@esiha.org.

 

Parent Signature:_______________________                Date:________________

Print Name:____________________________