3010 Geary Blvd.

San Francisco, CA. 94118

     (415) 742-4890

   Consent, Release of Liability, Indemnity, Assumption of Risk,

    Medical Consent, and Photographic Release (the “Agreement”)

Participant’s Name _______________________________________________ Age ________ Birthday ____________________

Address ________________________________________________________________________________________________

Work Phone _______________________ Home Phone _________________________ Cell Phone ________________________

Email __________________________________________________________________________________________________

The term “Participant” in this Agreement shall refer to myself. The Term “Releasors” shall refer to myself together with my family, spouse or significant other, my estate, heirs, assigns, personal representatives, and next of kin. The San Francisco Baseball Academy shall be referred to as the SFBA and shall be deemed to additionally include its owners, employees, contractors, sponsors, successors, assigns, and any associated personnel. The SFBA, as so defined, shall sometimes be referred to as the “Releasees”.

I wish  to attend and participate in activities (the “Program”) at the SFBA. I understand that participation in the Program involves certain risks, including but not limited to, serious injury. With full knowledge of the danger involved, I hereby agree to assume all risks of such participation.

In return for being allowed to participate in the Program at the SFBA, I and the other Releasors agree not to sue the Releasees and release and forever discharge the Releasees from and against any and all claims of negligence, gross negligence, other liability, demands for personal injury-- including for accident, sickness, or death-- or for property damage or expenses, of any nature whatsoever, that may be suffered or incurred by me or and of the Releasors. This release is intended to be a full, complete and unconditional release of the Releasees from liability and against any and all claims of any type, nature, and description, to the maximum extent permitted by law. If any of my representations in this Agreement are false, I agree to indemnify, hold harmless, and defend the Releasees against any claims, actions, suits, procedures, costs, expenses, damages, and liabilities, including attorney’s fees, which would not have been suffered had the representation been true.

I, as the Participant, grant permission to the Released Parties to authorize and obtain emergency medical care and treatment from any licensed physician, hospital or medical clinic, deemed necessary by a duly licensed physician should I become ill or injured and when I am not available to grant authorization myself for such emergency treatment. This authorization includes the administration of first aid and transportation to and from a medical treatment facility.

My voice, image, likeness, and performance may be recorded by mechanical, photographic, or electronic means (collectively referred to as “Recordings”). The SFBA is hereby granted ownership of such Recordings, and has my permission to display, reproduce, use and distribute such Recordings in any manner it sees fit, without further compensation or right or review.

I, as the Participant, represent that I am over the age of 18  and can lawfully bind myself  and the Releasors to the terms of this Agreement. I have read this Agreement carefully, fully understand its terms, and understand that by signing this form, I and the other Releasors are giving up substantial legal rights and remedies that we otherwise have including our right to sue. By my signature, which is affixed freely and voluntarily without any inducement, I intend to bind all of the Releasors to all of the provisions of this Agreement as if each had individually signed it, to the extent permitted by law.

Signature (Responsible Party) ____________________________________________________  Date ______________________