Neighborhood Athletics Waiver 2023/2024

Welcome to Neighborhood Athletics! Through our youth development programs, we aim to enhance our student’s strength and to promote positive outcomes by providing necessary resources. We believe there’s a need for a deeper connection with our youth leaders. Our goal is to educate, guide, and assist our youth in different areas of life. Parents please compete and sign this waiver for your child to participate in any neighborhood athletics programming.

Please Select all of the programs you are interested in:

Student Name*

First NameLast Name

Date Of Birth *

Date

Grade *

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

School Name *

Medical Conditions*

Food allergies *

Parent/ Guardian Name*

First NameLast Name

Parent/ Guardian Name

First NameLast Name

Home Phone*

Please enter a valid phone number.

Cell Phone

Please enter a valid phone number.

Parent/Guardian Email*

example@example.com

Emergency Contact

Name*

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

Neighborhood Athletics Parent Release Form for Children/Youth Media Recording

I, the undersigned, do hereby grant permission to use the image of my child, (NAMED ABOVE) Such use includes the display, distribution, publication, transmission, or otherwise use of photographs, images, and/or video taken of my child for use in materials that include, but may not be limited to, printed materials such as brochures and newsletters, videos, and digital images such as those on the Web site. I give unrestricted permission for my child’s image to be used in print, video, and digital media. I agree that these images may be used for a variety of purposes and that these images may be used without further notifying me.

Legal Parent/ Guardian Signature*

Date*

Date

READ BEFORE SIGNING
THIS DOCUMENT CONTAINS STATEMENTS THAT YOU WILL GIVE UP LEGAL RIGHTS.

NEIGHBORHOOD ATHLETICS
Parental Waiver, Release of Liability, Indemnification and
Consent Form

I, the undersigned, as the parent or legal guardian of the child/children named above, do hereby give my full consent and approval for my child/children to participate in Neighborhood Athletics Youth Programming (referred to in this form as “Activity”)

I understand that the very nature of the Activity is hazardous and risky. I understand that there are certain risks of bodily injury, death or property damage that may occur during or as a result of participation in the Activity. I agree to assume all of these risks on behalf of my child/children. These risks include, but are not limited to, those hazards associated with other participants, volunteers, instructors, equipment, my child’s/children’s health condition(s), and others not known to me.

Further, I agree that in consideration for the right to allow my child/children to participate in the Activity:

On behalf of my child/children and myself, I do voluntarily elect to accept and solely assume all risks of damage, theft and/or injury incurred or suffered by my child/children: (a) while participating in the Activity; (b) while observing others participate in the Activity; and (c) while on or upon the premises of any and all of the locations arranged for performance of the Activity.

In addition to giving my full consent for my child’s/children’s participation, I do hereby waive, release, discharge and agree not to sue Neighborhood Athletics (and its subsidiaries, including but not limited, to , its affiliates, directors, officers, employees, volunteers, agents, and contractors (“Releasees) for any claim, damages, costs including attorney fees, or cause of action which I or my child/children have or may have in the future as a result of damages, injuries, including death, sustained or incurred by my child/children from whatever cause including, but not limited to, my child’s/children’s conduct and/or the negligence or wrongful conduct of the parties of the Releasees.

I agree on behalf of myself and my child listed below, that I shall hold harmless and fully indemnify the Releasees from any and all claims, damages, costs including attorney fees, and causes of action which may arise from any cause of action made by me or by, through or on behalf of my child, even if the damages, injuries or death are caused in whole or in part by any of the Releasees.

I agree that if any portion of this Form is determined by a court of law to be invalid, that the remainder will continue in full force and effect. I further agree that the contents of this Form shall be construed to provide the broadest waiver, release, indemnification, and consent possible.

I acknowledge: (a) that I have read each and every one of the provisions in this Form; (b) that I understand each of the provisions in this Form; and (c) that I agree to abide by them.

Legal Parent/ Guardian Signature*

Date*

Date