VolleyOC Huntington Beach Clinic Registration
Participant First Name *
Participant Last Name *
Parent/Guardian Name *
Primary Contact phone number *
Primary Contact email address *
Secondary Contact Name *
Secondary Contact Phone Number *
Address *
City *
Zip code *
Sessions *
Waiver agreement *
In consideration of participation in the Program, I (We), the undersigned, recognize, agree and acknowledge as follows: (1) Participation in the Program is voluntary; (2) Follow and abide by the rules, regulations, guidelines and Participant Code of Conduct (3) The participant is in good health, physically able to participate in the program without restrictions and has no medical condition that would or may cause participation to be potentially hazardous to his or her health, which VolleyOC can request participant to agree to furnish medical documentation at participants own expense; (4) Failure to disclose a medical condition could terminate participation; (5) There is a real possibility that participant could be seriously injured while participating in the Program; (6) Participant assumes all risks associated with participation in the Program. Participant acknowledges the inherent and potential dangers of participating and expressly waives and voluntarily assumes all risk of personal injury or death which may be sustained while participating . I (WE) RECOGNIZE THAT REGISTRATION IN THE PROGRAM IS DANGEROUS AND CONTAINS RISK OF PERSONAL INJURY, DEATH, DISABILITY, PROPERTY DAMAGE OR LOSS (“DAMAGES”). I ASSUME ANY AND ALL RISKS associated with my or my child’s participation in the Program, including, but not limited to, strenuous physical activity or exertion; striking or being struck, by objects or persons; slipping; and exposure to heat, cold or humidity. Such risk may result in injuries that include, but are not limited to: sprain, strain or tear of muscles or ligaments; fracture or dislocation of joints or bones; head or facial injuries; spinal cord or internal injuries. I know that the risks, hazards and dangers include, but are not limited to, falling, slipping, colliding with other users, staff or spectators. I understand that these risks, hazards and dangers are further increased when other persons, whether or not of the same level of experience, are present at the same time and/or using the same facilities. ALL SUCH RISKS ARE KNOWN AND APPRECIATED BY ME. I hereby, for myself, my child, heirs, or anyone who might claim on my or my child’s behalf, agree not to bring any claim, and waive, release and forever discharge Volley OC, and all of their officers, agents, and employees from any and all duty to me, my child and/or liability for damages arising out of or in the course of my child’s participation in the Program, including all liability for any active or passive negligence by VolleyOC and/or their officers, agents and employees. This release and waiver extends to all claims of every kind or nature whatsoever, foreseen or unforeseen, known or unknown. I waive and voluntarily assume all risk of personal injury which may be sustained while participating. The laws of the State of California shall govern this agreement. The undersigned, hereby acknowledged to be lawful parent(s) and/or guardian(s) of the participant, acknowledge(s) my/ our qualifications to sign the Release on behalf of the participant.
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