WAIVER AND RELEASE OF LIABILITY

 

Please read this form carefully and be aware that in participating you will be waiving and releasing all claims for injuries that you or your minor child/ward might sustain arising out of this participation.

 

As a participant or parent/guardian of a participant (hereinafter both or either referred to as “Participant”), I recognize and acknowledge that there are certain risks of physical injury and agree to assume the full risk of any injuries, including death, damages, or loss which Participant may sustain as a result of participating in any and all activities connected with or associated with this program.

 

In consideration of Participant’s participating in the activities sponsored or provided by the City of Milford, Participant, on behalf of Participant and Participant’s successors, assigns, and heirs,  hereby irrevocably and unconditionally waives, releases, acquits, forever discharges, and relinquishes all claims Participant may have against the City of Milford and its officials, officers, agents, representatives, servants, attorneys ,employees, successors, assigns, heirs, subsidiaries, and related entities as a result of participating. I do hereby fully release and discharge the City of Milford and its officials, officers, agents, representatives, servants, attorneys, employees, volunteers, successors, assigns, heirs, subsidiaries, and related entities from any and all claims from injuries, including death, damages, or loss of any kind or nature whatsoever which Participants may have at any time or which may incur or may accrue Participant based on, arising out of, or related in any way either directly or indirectly to Participant’s participation in the activities sponsored or provided by the City of Milford.

 

I further agree to indemnify and hold harmless and defend the City of Milford and its officials, officers, agents, representatives, servants, attorneys, employees, volunteers, and related entitiesfrom any and all claims resulting from injuries, including death, damages and losses of any kind or nature whatsoever sustained by Participant based on, arising out of, or related in any way either directly or indirectly to activities of Participant’s participation.

 

In accordance with Nebraska Statute 71-9105 (2011), parents and coaches must review the provided items that address the following:

 

1) The Signs and Symptoms of a Concussion;

 

2) The Risks Posed by Sustaining a Concussion; and,

 

3) The Actions an athlete should take in response to sustaining a concussion, including the notification of his or her coaches.

 

(More information is available at www.cdc.gov/concussion/HeadsUp/youth.html)

By signing up online I acknowledge that I have read and fully understand the above warning of Risk and Waiver and Release of All Claims and have received information in accordance with Nebraska Statute 71-9105 regarding concussions.