River Valley Girls Travel Basketball / Liability Form 2020-2021 Season
WAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT
In consideration for participating in the River Valley Girls Basketball Program (hereinafter the “Program”), I, on behalf of myself and any minor child/children for whom I have the capacity to contract, hereby acknowledge and agree to the following:
1. I understand the hazards of the novel coronavirus (“COVID-19”) and am familiar with the Centers for Disease Control and Prevention (“CDC”) guidelines regarding COVID-19. I acknowledge and understand that that the circumstances regarding COVID-19 are changing from day to day and that, accordingly, the CDC guidelines are regularly modified and updated and I accept full responsibility for familiarizing myself with the most recent updates.
2. Notwithstanding the risks associated with COVID-19, which I readily acknowledge, I hereby willingly choose to participate in the Program.
3. I acknowledge and fully assume the risk of illness or death related to COVID-19 arising from participation in the Program and hereby RELEASE, WAIVE, DISCHARGE, AND COVENANT NOT TO SUE (on behalf of myself and any minor children form whom I have the capacity contract) the River Valley Girls Basketball Program, officers, directors, agents, coaches and assigns (the “RELEASEES”) from any liability related to COVID-19 which might occur as a result my participating in the Program.
4. I shall indemnify, defend and hold harmless the RELEASEES from and against any and all claims, demands, suits, judgments, losses or expenses of any nature whatsoever (including, without limitation, attorneys’ fees, costs and disbursements, whether of in-house or outside counsel and whether or not an action is brought, on appeal or otherwise), arising from or out of, or relating to, directly or indirectly, the infection of COVID-19 or any other illness or injury.
5. It is my express intent that this Waiver and Hold Harmless Agreement shall bind any assigns and representatives, and shall be deemed as a RELEASE, WAIVER, DISCHARGE, AND COVENANT NOT TO SUE the above-named RELEASEES. This Agreement and the provisions contained herein shall be construed, interpreted and controlled according to the laws of the State of Massachusetts. I HEREBY KNOWINGLY
AND VOLUNTARILY WAIVE ANY RIGHT TO A JURY TRIAL OF ANY DISPUTE ARISING IN CONNECTION WITH THIS AGREEMENT. I ACKNOWLEDGE THAT THIS WAIVER WAS EXPRESSLY NEGOTIATED AND IS A MATERIAL INDUCEMENT THE PERMISSION GRANTED BY RELEASEES TO BE ON PREMISES AND PARTICIPATE IN THE ACTIVITIES.
IN SIGNING THIS AGREEMENT, I ACKNOWLEDGE AND REPRESENT THAT I have read the foregoing Wavier of Liability and Hold Harmless Agreement, understand it and sign it voluntarily as my own free act and deed; no oral representations, statements, or inducements, apart from the foregoing written agreement, have been made; I am at least eighteen (18) years of age and fully competent; and I execute this Agreement for full, adequate and complete consideration fully intending to be bound by same.
Town/Program your daughter is playing in:
Grade of the team that your daughter is playing on:
Your daughter's FIRST and LAST name:
Parent/guardian filling out the waiver (FIRST and LAST name):
IN WITNESS WHEREOF, I have signed this Waiver and Agreement under seal on the date I listed above. By stating my name below, this will serve as an electronic signature. Please write FIRST AND LAST NAME below.
Page 1 of 1
Never submit passwords through Google Forms.
This form was created inside of Winthrop Public Schools.