MISSOURI HIGH SCHOOL RACQUETBALL LEAGUE 2021-2022 -- LAFAYETTE/ROCKWOOD ATHLETE
Every participant participating in the 2021-2022 MOHSRA League must complete and submit.  
Sign in to Google to save your progress. Learn more
WAIVER AND RELEASE OF LIABILITY *
In consideration of being allowed to participate in any way in any of the athletic/sports programs and related activities with the following entities, the undersigned agrees to the following: A. Releasees. The term “Releasees” shall mean “Veta, LLC; SPI, Inc.; Westchester Tennis & Sports Center, LLC; St. Charles Indoor Sports, LLC; Vetta West, LLC;  and Westplex Sports LLC” the foregoing’s clubs, respective administrators, directors, agents, coaches, other employees of the organizations, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of the premises used to conduct an event; and other individuals participating in Vetta Sports athletic/sports programs and related activities. “Veta, LLC; SPI, Inc.; Westchester Tennis & Sports Center, LLC; St. Charles Indoor Sports, LLC; Vetta West, LLC; Westplex Sports LLC” are individual Missouri corporations or individual Missouri LLCs. B. Inspection and Reporting of Unsafe Conditions. The undersigned shall, prior to participating, inspect the facilities and equipment to be used, and if he/she believes anything is unsafe, he/she will immediately advise his/her coach or supervisor of such condition(s) and refuse to participate. C. Understanding and Assumption of Risk. The undersigned understands that, by participating, he/she will be engaging in activities that involve risk of serious injury, including permanent disability and death and severe social and economic losses which might result from his/her own actions, inaction or negligence of others, the rules of play, or the condition of the premises or of any equipment used. Further the undersigned understands that by participating in and engaging in the athletic/sports programs and related activities, inflatable activities, and birthday parties provided by the entities herein, that communicable disease and diseases (including but not limited to the coronavirus/COVID, which participant acknowledges is believed to be extremely contagious and can be spread by various person-to-person contact, respiratory droplets, and contact with surfaces around infected persons) may be transmitted by contact with or close proximity to other participants or instructors/employees of the entities. The undersigned further understands that there may be other risks not known or reasonably foreseeable at this time. The undersigned assumes all the foregoing risks and accepts personal responsibility for damages which may hereinafter occur following such injury, permanent disability, or death. D. RELEASE OF LIABILITY. THE UNDERSIGNED RELEASES, WAIVES, DISCHARGES, AND COVENANTS NOT TO SUE RELEASEES from demands, losses, or damages on account of injury, illness, emotional distress, death, and potential exposure or actual exposure to communicable disease or diseases (including but not limited to coronavirus/COVID-19, other viruses, bacteria, and all other infectious pathogens and disease vectors), caused or alleged to be caused in whole or in part by the negligence of the Releasees. In addition to RELEASING THE RELEASEES AND ASSUMING THE RISK OF INJURY AND DAMAGES, the undersigned shall indemnify and hold harmless the Releasees as to any claims for injury and damage caused by the negligence of Releasees. This Agreement & Waiver and Release of Liability does not, however, apply to gross negligence or intentional torts by Releasees. E. Health Insurance. The undersigned shall carry personal health insurance in case of a sports injury. F. Consent to Use Undersigned’s or Undersigned’s Child’s Image. The undersigned consents to and grants his/her permission for “Veta, LLC; SPI, Inc.; Westchester Tennis & Sports Center, LLC; St. Charles Indoor Sports, LLC; Vetta West, LLC;  and Westplex Sports LLC” to use the undersigned’s or the undersigned’s child’s image on any reproduction for marketing purposes, including but not limited to brochures, banners, websites, social media, print, video, and billboards. THE UNDERSIGNED HAS READ THE ABOVE AGREEMENT & WAIVER AND RELEASE AND UNDERSTANDS THAT HE/SHE HAS GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING AND DOES SO VOLUNTARILY.
Required
USA RACQUETBALL EVENT RELEASE FORM *
I ACKNOWLEDGE THAT BY SIGNING THIS DOCUMENT, I AM ASSUMING ALL RISKS OF INJURY OR DAMAGE. I, FOR MYSELF AND ANY PERSONAL REPRESENTATIVES, HEIRS AND ASSIGNEES, HEREBY AGREE TO INDEMNIFY, RELEASE, WAIVE, FOREVER DISCHARGE, AND NOT TO SUE THE ORGANIZER OF THIS EVENT, USA RACQUETBALL (USAR), USAR’S AFFILIATED STATE ASSOCIATIONS, AND USA RACQUETBALL FOUNDATION (USRF), AND THEIR RESPECTIVE AGENTS, EMPLOYEES, VOLUNTEERS, MEMBERS, CLUBS, SPONSORS, PROMOTERS, CONTRACTORS, REPRESENTATIVES, PARENT COMPANIES, SUBSIDIARIES, DIVISIONS, AFFILIATES, INSURERS, PREDECESSORS, SUCCESSORS AND ASSIGNS (COLLECTIVELY “RELEASEES”), OF AND FROM ANY AND ALL CLAIMS, DEMANDS, ACTIONS, CAUSES OF ACTION, SUITS, COSTS, LOSSES, INJURIES, DAMAGES, EXPENSES AND LIABILITY (COLLECTIVELY, “LOSSES”) ARISING OUT OF, RELATED TO, OR IN ANY WAY CONNECTED WITH, DIRECTLY OR INDIRECTLY, MY PARTICIPATION IN OR ATTENDANCE AT THE EVENT (AND MY TRAVEL TO OR FROM THE EVENT), INCLUDING, WITHOUT LIMITATION, ANY LOSSES CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF ANY OF THE RELEASEES. I ACKNOWLEDGE AND AGREE THAT THIS RELEASE IS A CONTRACT WITH LEGAL AND BINDING CONSEQUENCES AND IT APPLIES TO ALL COMPETITIONS AND ACTIVITIES AT THE EVENT AND THE USE OF THE FACILITY. In consideration of the opportunity to attend, observe, and/or participate in the event, I hereby freely agree to and make the following contractual representations and agreements. I acknowledge that racquetball is an inherently dangerous sport involving a risk of serious injury or death and I fully acknowledge the dangers of attending, observing and/or participating in this event, whether as a player, official, coach, volunteer, or otherwise, and I fully assume the risks associated with such attendance, observation and/or participation, by way of example, and not limitation: dangers associated with playing in close proximity to competitors, inadequate safety equipment, and the dangers associated with court surface inadequacies. I agree it is my sole responsibility to be familiar with the event courts and agenda, the Releases’ rules, and any special regulations for the event and agree to comply with all such rules and regulations. I understand and agree that situations may arise during the event which may be beyond the control of the Releases, and I must continually compete and otherwise participate so as to neither endanger myself nor others. I accept responsibility for the condition and adequacy of my equipment, any equipment provided for my use, and my conduct in connection with this event. I will wear an eye guard which satisfies the requirements of the Releases’ Participant Rules or Regulations and that can protect against serious eye injury, and assume all responsibility and liability for the selection of such an eye guard. I represent that I am in good physical health and have no prior injuries or known physical disabilities which would endanger myself or others if I participate in this event. I understand that drug testing may be conducted for athletes registered for this event and hereby consent to such testing as further consideration for the opportunity to participate in the event. I HEREBY CONSENT TO RECEIVE MEDICAL TREATMENT WHICH MAY BE DEEMED ADVISABLE IN THE EVENT OF INJURY, ACCIDENT AND/OR ILLNESS DURING THE EVENT. I agree that the above representations are contractually binding, and are not mere recitals, and that should I or anyone acting on my behalf assert a claim contrary to what I have agreed to in this contract, the claiming party shall be liable for the expenses (including attorneys’ fees and costs) incurred by the Releases in defending the claims. This contract may not be modified orally, and a waiver or modification of any provision shall not be construed as a waiver or modification of any other provision herein or as a consent to any subsequent waiver or modification. I consent to the release by any third party to Releases and their insurance carriers of my name and medical information that may relate solely to any injury or death I may suffer arising from the event. Every term and provision of this contract is intended to be severable. If any one or more of them is found to be unenforceable or invalid, that shall not affect the other terms and provisions, which shall remain binding and enforceable. I give the USAR, IRT, IRT Network, and the US Olympic Committee (USOC), the absolute right and permission to use my image or likeness as part of any live or recorded video display or other transmission, reproduction or depiction of video or photographs for any legitimate business purpose. I release USAR, the photographer, their respective officers, employees, agents, and designees from liability for any violation of any personal or proprietary right I may have in connection with such use. I am 18 years of age or older and am of legal age of consent in the jurisdiction of the event with no legal disabilities that prevent me from being legally bound by this Release (unless my parent or legal guardian has executed this Release). I am capable of reading and understanding the written English language.  
Required
Participant Name *
Participant Date of Birth *
MM
/
DD
/
YYYY
Participant Year in School *
CONSENT AND RELEASE OF PARENT OR GUARDIAN *
I am the parent or guardian of the above signed participant (Child). My Child is fit for the event, and I consent to my Child’s participation. I HAVE READ AND I UNDERSTAND THE ABOVE CONTRACT. In consideration of allowing my Child to participate, I consent to the contract and agree that its terms shall likewise bind me, my Child, and our respective personal representatives, heirs and assignees. I HEREBY RELEASE AND SHALL DEFEND, INDEMNIFY AND HOLD HARMLESS THE RELEASEES FROM EVERY CLAIM AND ANY LIABILITY that I or my Child may allege against the Releases (including reasonable attorneys’ fees and costs) as a direct or indirect result of damage to property or injury or death to me or my Child because of my Child’s participation in the event, INCLUDING, WITHOUT LIMITATION, ANY CLAIM OR LIABILITY CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF ANY OF THE RELEASEES. I, ON BEHALF OF MYSELF AND MY CHILD, OUR PERSONAL REPRESENTATIVES, HEIRS AND ASSIGNEES, PROMISE NOT TO SUE ANY OF THE RELEASEES ON MY BEHALF OR ON BEHALF OF MY CHILD REGARDING ANY CLAIM ARISING FROM MY CHILD’S PARTICIPATION IN THE EVENT. I give the USAR, IRT, IRT Network, and the USOPC, the absolute right and permission to use my Child’s image or likeness for any legitimate business purpose, and I release USAR, the photographer, their officers, employees, agents, and designees from liability for any violation of any personal or proprietary right I may have in connection with such use.
Required
Parent/Guardian Name *
Street Address *
City *
State *
Zip Code *
Cell Phone Number *
Home Phone Number *
E-Mail Address *
Emergency Contact Name *
Relationship to Participant *
Emergency Contact Cell Phone Number *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Vetta Sports. Report Abuse