2023 World Pickleball Open                                MEDICAL RELEASE FORM
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Event date (circle one): *
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Participant Name (Last Name, First Name) *
Last Name, First Name
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PRIMARY Cell Phone *
Important: Where we can reach you if needed
SECONDARY Phone *
Important: Where we can reach you if not available on PRIMARY phone #

RELEASE, PERMISSION, AND INDEMNITY AGREEMENT

Release.  In consideration of being permitted to participate in any way in the 2023 World Pickleball Open (“the Event”); practice November 14 – 16, 2023, match play from Nov. 16 – 19, 2023. I, for myself, my heirs or assigns, hereby release, waive, discharge and covenant not to sue USA Pickleball as well as: Players International Management, Inc., Match Point, Inc., Palm Beach Gardens Tennis Center, Kolter Homes, Palm Beach Sports Commission, Event Sponsors and staff, their officers, employees and agents from liability from any and all claims resulting in personal injuries, death, accidents, illnesses (such as communicable diseases including COVID-19), and property loss arising from, but not limited to, participation in the Event.

Assumption of Risk.  Participation in the Event carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries.  The specific risks vary but include 1) minor injuries such as bruises, sprains and dehydration, 2) major injuries such as eye injuries, joint or back injuries, heat stroke, heart attacks, and concussions, and 3) catastrophic injuries such as paralysis and death.  I have read the previous paragraphs and I know, understand and appreciate these and other risks that are inherent in playing pickleball.  I assert that my participation is voluntary and that I knowingly assume all such risks.

Indemnification and Hold Harmless.  I also agree to indemnify and hold USA Pickleball and all named above harmless from any and all claims, actions, suits, costs, expenses, damages and liabilities, including attorney’s fees brought as a result of my involvement in the Event. 

Use Permission.  I also give USA Pickleball and its agents and designees permission to use or distribute, without limitation or obligation, my image, name, voice, and words for any purpose connected with the Event, including promotional, marketing, training, informational, and archival uses.

Initial Here *
I, FOR MYSELF, MY SPOUSE, AND CHILD/WARD, HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT WE HAVE GIVEN UP SUBSTANTIAL RIGHTS BY INITIALING IT, AND INITIAL IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
Initial of Guardian (if Participant is under 18) or Initial of Participant (if over 18)* *
Print Guardian Name (if player under 18):
UNDERSTANDING OR RISK
I understand the seriousness of the risks involved in participating in this program, my personal responsibilities for adhering to rules and regulation, and accept them as a participant.
Print Participant Name (if player 18 or older):
Date Initialed: *
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THANK YOU and GOOD LUCK from all of us!
A copy of your responses will be emailed to the address you provided.
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