2019 Pole Sport Organization Human Prop Registration
This is for human props to sign the required liability waivers. This is NOT a ticket to watch the show. Each human prop needs to purchase a ticket to watch the show.

Human props may touch the competitor, but not the pole. Judging will be based on the skills and abilities of the competitor only, and not the skills and abilities of the human prop. Human props must have a spectator ticket to the section in order to participate as a prop and must be 18 years of age or older. They are required to sign a waiver of liability before participating in the show.

Human props are allowed to enter and exit the stage during the performance, but may not enter or exit from anywhere other than the sides of the stage (ex. jumping off the front of the stage is not allowed).

A competitor using props without approval is subject to disqualification or point deduction.

Your name *
Your answer
Your email *
Your answer
Name of competition (Pacific, Taiwan, Switzerland, etc) *
Your answer
Name of competitor whose routine you are in *
Your answer
By checking the box, I certify that I am 18 years of age or older. *
By checking the box, I agree to the waiver of liability: By checking the box below, I agree to the following waiver of liability: RELEASE, WAIVER AND INDEMNITY AGREEMENT and AGREEMENT TO ASSUME RISK OF POTENTIALLY HAZARDOUS ACTIVITY For good and valuable consideration (value), the receipt and sufficiency of which is hereby conclusively acknowledged, including being permitted to enter an event venue holding a performance or competition sanctioned by Pole Sport Organization LLC, or any other location, (the “Event Venue”) for any purpose, including but not limited to observation, use of facilities or equipment, or participation in any way, including training, performing, volunteering, judging, and/or competing in pole dance and/or lyra and/or silks, (collectively “the Aerial Arts”, which is a potentially hazardous activity):The undersigned hereby acknowledges, agrees and represents that he or she, immediately upon entering, will inspect such Event Venue and facilities. It is further warranted that such entry in the Event Venue for observation, participation or use of any facilities or equipment is an acknowledgment that such Event Venue, and all facilities and equipment inside have been inspected, and that the undersigned finds and accepts same as being safe and reasonably suited for the purposes of such observation or use.In further consideration of being permitted to enter the Event Venue for any purpose, including but not limited to observation, use of facilities or equipment or participation in any way, including the Aerial Arts, the undersigned hereby agrees to the following:THE UNDERSIGNED HAS OBTAINED OR WILL OBTAIN AN APPROPRIATE MEDICAL CHECKUP, BEFORE COMMENCING ANY AERIAL ARTS TRAINING, WITH A PHYSICIAN TO VERIFY THAT AERIAL ARTS TRAINING IS APPROPRIATE FOR THE UNDERSIGNED’S PHYSICAL CONDITION. IF THE PHYSICIAN DISAPPROVES OR APPROVES BUT ONLY SUBJECT TO CERTAIN CONDITIONS, THE SAME SHALL BE COMMUNICATED IN WRITING TO POLE SPORT ORGANIZATION LLC AS A PRECONDITION TO ENROLLING IN PERFORMANCE, COMPETITION, CLASS, OR TRAINING.THE UNDERSIGNED HEREBY RELEASES, WAIVES, DISCHARGES AND COVENANTS NOT TO SUE POLE SPORT ORGANIZATION LLC, and any of their officers, directors, instructors, employees, agents, and co-participants (hereinafter referred to as “Releasees”) from all liability to the undersigned for any loss or damage, and any claim or demands on account of injury to the person or property or resulting in death of the undersigned, whether caused by the negligence, pre-existing medical condition, or physical over-exertion of the undersigned or otherwise, while the undersigned is in, upon or about the Event Venue or any facilities or equipment. This includes without limitation injuries or damages which may result from physical contact with participants or instructors, slipping or tripping and falling due to a dangerous condition of the property, improper maintenance of the Event Venue or equipment, inadequate security, inadequate supervision, and/or improper or negligent instruction.THE UNDERSIGNED HEREBY AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS THE RELEASEES and each of them from any loss, liability, damage or cost they may incur due to the presence of the undersigned in, upon or about the Event Venue or in any way observing or using any facilities or equipment of at the Event Venue, whether caused by the negligence of the Releasees or otherwise.THE UNDERSIGNED HEREBY ASSUMES FULL RESPONSIBILITY FOR AND RISK OF BODILY INJURY, death or property damage due to the negligence of Releasees while in, upon or about the Event Venue or while using the Event Venue or any facilities or equipment hereon.THE UNDERSIGNED FURTHER EXPRESSLY AGREES THAT THE FOREGOING RELEASE, WAIVER AND INDEMNITY AGREEMENT AND AGREEMENT TO ASSUME RISK OF POTENTIALLY HAZARDOUS ACTIVITY IS INTENDED TO BE AS BROAD AND INCLUSIVE AS IS PERMITTED BY THE LAW OF THE STATE OF CALIFORNIA and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.THE UNDERSIGNED HAS READ AND VOLUNTARILY SIGNS THE RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT AND ASSUMPTION OF RISK OF POTENTIALLY HAZARDOUS ACTIVITY, AND FURTHER AGREES THAT NO ORAL REPRESENTATIONS, STATEMENTS OR INDUCEMENTS APART FROM THE FOREGOING WRITTEN AGREEMENT HAVE BEEN MADE. FURTHERMORE, THE UNDERSIGNED UNDERSTANDS THAT NO ONE AT AN EVENT VENUE IS AUTHORIZED TO MODIFY THIS AGREEMENT.I fully understand that if any medical treatment is provided to me, with or without my consent, such treatment will be first aid type treatment, and I waive any and all claims or causes of action arising from or based upon the provision of such treatment, including claims or causes of action based upon the negligent provision of such treatment.By participating in or attending any activity in connection with Pole Sport Organization LLC, whether inside or outside the Event Venue, I consent to the use of any photographs, pictures, film or videotape taken of me or provided by me for publicity, promotion, television or any other use, and expressly waive any right of privacy, compensation, copyright or other ownership right connected to same.No amendment, modification, or supplement to this Agreement shall be binding unless it is in writing and signed by the parties. This Agreement is the entire agreement between the parties. This Agreement supersedes all previous agreements. If any term or provision of this Agreement is determined to be illegal, unenforceable, or invalid in whole or in part for any reason, such provisions shall be stricken from this Agreement, and shall not affect the legality, enforceability, or validity of the remainder of this Agreement. Each person signing this Agreement represents and warrants that he or she is duly authorized and has legal capacity to execute and deliver this Agreement, including the parents or guardians of any minor. This agreement shall bind the parents, heirs, executors and assigns of the undersigned.I HAVE CAREFULLY READ THIS RELEASE. I HAVE NO QUESTIONS TO ASK PRIOR TO SIGNING THIS AGREEMENT. THIS IS A LEGAL DOCUMENT AND I HAVE HAD THE OPPORTUNITY TO CONSULT MY ATTORNEY BEFORE SIGNING IT. I AGREE THAT ANY AMBIGUITY IN THIS AGREEMENT SHALL NOT BE INTERPRETED AGAINST POLE SPORT ORGANIZATION LLC WHO WROTE IT. Signing this agreement shall apply to all performances or competitions sanctioned by Pole Sport Organization LLC during calendar year 2019. *
By checking the box, I agree to the following image release: For valuable consideration, the adequacy of which is acknowledged, for you photographing me, and knowing you have and will expend substantial expenses and time on the reliance upon this Release and Consent, I irrevocably and absolutely consent to the unrestricted use by ALLOY IMAGES and its/his successors, assigns, and designees (“Photographers”), and those acting with Photographer’s permission and authority, of my name and any and all photographic or other images (“Images”) of me that Photographer creates or makes, for all purposes, in any form, in any and all media, including, without limitation, advertising, solicitation, or trade.I waive any right to inspect or approve the finished Images, advertising copy, text, or other printed material that may be used in conjunction therewith, or to the eventual use that the Images may be applied. I release and discharge Photographer and those acting under Photographer’s authority from any and all liabilities, claims and demands arising out of or relating to any blurring, distortion, or alteration, whether intentional or otherwise, that may occur or be produced in connection with the Images, or in connection with any processing, alteration, transmission, display, publication, or other use of the Images.This Agreement constitutes the sole, complete, and exclusive agreement between Photographer and me regarding the Images and I am not relying on any other representation whether written or oral. *
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