PLEASE READ CAREFULLY AND SIGN BELOW TO INDICATE YOUR AGREEMENT.
NOTE: THIS FORM INCLUDES A RELEASE OF LIABILITY
Ultimate Fieldhouse/Ultimate Sports Association
Consent, Release and Waiver
I the undersigned, am the above named individual or legal guardian for the individual. As an inducement for and in consideration of the agreement by Ultimate Sports Association to allow the above named individual (“Participant”) to participate in the athletic activities at the Ultimate Fieldhouse (“Activities”), the undersigned parent or legal guardian of the Participant hereby acknowledges and agrees as follows:
1. I have considered, understand and appreciate that there is a risk of serious and possibly permanent injury, including brain damage or death, to me as a result of my participation in the Activities and, I KNOWINGLY AND FREELY ASSUME THOSE AND ALL OTHER RISKS, known and unknown, related to my engagement in the Activities, including but not limited to RISKS ARISING FROM THE NEGLIGENCE OF OTHERS.
2. I consent to the provision of medical care, evaluation and treatment onsite at the Ultimate Fieldhouse by Ultimate Sports Association, and their respective, officers, employees, agents and contractors (collectively, “Onsite Providers”). I also consent to the provision of medically necessary diagnostic and therapeutic care, evaluation and treatment, including imaging, anesthesia administration, and surgery, at inpatient and outpatient facilities, including acute care hospitals, in the case of a medical emergency, or if I am unable to provide consent or my duly authorized attorney-in-fact-is unable to respond in a timely manner. I also consent to disclosures of legally protected medical information about me between (a) Onsite Providers, (b) Onsite Providers and the head coach and other duly authorized representatives of my team, and (c) between Onsite Providers and third parties in connection with the delivery of medical care and treatment to me. I will be and remain legally responsible to pay the cost of medical and dental care, evaluation and treatment furnished to me, other than the care, evaluation and treatment furnished by the Onsite Providers at the Ultimate Fieldhouse.
3. I hereby RELEASE and AGREE TO HOLD HARMLESS the Onsite Providers, and each of them, from and against any and all claims, demands, damages, causes of action or other liability arising from any injury or other loss or damage to person or property, known and unknown, that I may suffer directly or indirectly as a result of my participation in the Activities, EVEN IF SUCH INJURY, LOSS OR DAMAGE ARISES FROM THE NEGLIGENCE OF THE ABOVE RELEASED PARTIES OR ANY OTHER PERSONS, to the fullest extent permitted by law.
4. I grant full consent and permission for Ultimate Sports Association, Ultimate Fieldhouse, each of their affiliates and sponsors, and each of their respective officers, partners, managers, employees, and agents, to use, for any purpose whatsoever, including, without limitation, commercial purposes, the name, likeness, image, and voice of the Participant, as well as any photographs or recordings of any type of the Participant taken or made before, during or after the Activities.
5. I hereby irrevocably consent to and authorize the use by The Ultimate Fieldhouse and/or Ultimate Sports Association, and each organization’s respective sponsors of any and all photographs, video, voice recordings, or other media taken of me including derivative works thereof (collectively, the “Images”), and any reproduction of them in any form in any media whatsoever, whether now known or hereafter created, throughout the world in perpetuity. I also consent to the use of my name or likeness, or an assigned fictitious name, in connection with the exhibition, distribution, merchandising, advertising, exploiting and/or publicizing of Images or The Ultimate Fieldhouse and/or Ultimate Sports Association and each organization’s respective sponsors. I hereby release and discharge The Ultimate Fieldhouse and/or Ultimate Sports Association, each organization’s respective sponsors, and their respective trustees, officers, employees, licensees, and affiliates from any and all claims, actions, suits or demands of any kind or nature whatsoever, in connection with the use of Images and the reproduction thereof as aforesaid. I understand and agree that The Ultimate Fieldhouse and/or Ultimate Sports Association will be the exclusive owner of all rights, including, but not limited to, all copyrights, in and to the Images in whole or part, throughout the universe, in perpetuity, in any medium now known or hereafter developed, and to license others to so use them in any manner The Ultimate Fieldhouse and/or Ultimate Sports Association may determine in its sole discretion, without any obligation to me. I hereby waive any right that I may have to inspect and/or approve the use of the Images or any reproductions thereof, by The Ultimate Fieldhouse and/or Ultimate Sports Association and each organization’s respective sponsors. I hereby release and discharge The Ultimate Fieldhouse and/or Ultimate Sports Association and each organization’s respective sponsors.
COVID Release, Waiver
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people.
The Ultimate Sports Association, a non profit 501C3 company that manages and operates out of the Ultimate Fieldhouse and its affiliate partners of Excel California, LLC, ASA Basketball, Flight Elite and Firehawks Basketball, (herin refered to as "Operators") have taken steps to reduce the risk of spread of COVID-19; however, Operators cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending Operator's activites could increase your risk and your child(ren)’s risk of contracting COVID-19.
By signing this agreement, I acknowledge the contagious nature of COVID-19 and VOLUNTARILY ASSUME THE RISK THAT MY CHILD(REN) AND I MAY BE EXPOSED TO OR INFECTED BY COVID-19 BY ATTENDING OPERATOR'S EVENTS AND THAT SUCH EXPOSURE OR INFECTION MAY RESULT IN PERSONAL INJURY, ILLNESS, PERMANENT DISABILITY, AND DEATH. I understand that the risk of becoming exposed to or infected by COVID-19 at Operator's events may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Operator's employees, volunteers, and program participants and their families.
I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my or my child(ren)’s attendance at Operator's events or participation in Operators programs (“Claims”). On my behalf, and on behalf of my children, I HEREBY RELEASE, COVENANT NOT TO SUE, DISCHARGE, AND HOLD HARMLESS USA, ITS EMPLOYEES, AGENTS, AND REPRESENTATIVES, OF AND FROM ALL CLAIMS, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of USA, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any Operators' program.
I expressly and knowingly waive all rights under California Civil Code Section 1542, which provides: "A general release does not extend to claims that the creditor or releasing party does not know or suspect to exist in his or her favor at the time of executing the release and that, if known by him or her, would have materially affected his or her settlement with the debtor or released party."
I HAVE READ THIS CONSENT AND PERMISSION, RELEASE AND WAIVER. I UNDERSTAND THE TERMS OF THIS CONSENT, RELEASE AND WAIVER AND SIGN IT FREELY AND VOLUNTARILY.