SPORTS PARTICIPANT CONSENT/MEDIA FORM

I, the undersigned ("Participant"), hereby consent to Participant's participation in and attendance allPrairie Grit Adaptive Sports (the "Activities"), with activity seasons beginning during the calendar yearlisted above, and all related ancillary activities, (the "Activities"), beginning during the calendar yearlisted above sponsored by Prairie Grit Adaptive Sports (the "Activities" In consideration of Participantbeing permitted to participate in and attend the Activities, I voluntarily and knowingly execute thisParticipant/Parental Consent, Waiver, and Release. I understand that the Activities involve physical athletic activities. I understand and acknowledge that the Activities and athletic activities involve inherent risks, hazards, and dangers for anyone participating and for those nearby that cannot be eliminated, particularly in the case of minors and particularly in the case of individuals with medical conditions. I understand and acknowledge that participation and attendance at the Activities involves the risk of bodily injury, death and/or paralysis. I, on behalf of myself and Participant, ACCEPT AND ASSUME ALL RISKS, HAZARDS AND DANGERS of Participant's participation in and/or attendance at the Activities, whether or not specifically identified above.

I understand that participation in Activities requires a certain degree of skill and knowledge and physical fitness. Participant has the requisite skill and knowledge and physical fitness to participant in theActivities. If Participant has any type of medical condition or disability, I represent that Participant has received clearance from his or her physician to participate in the Activities. Participant shall comply with all rules and instructions of Prairie Grit Adaptive Sports and its representatives while Participant is participating in or attending the Activities.

I, for myself and on behalf of Participant and our respective heirs, legal representatives and successors, WAIVE AND RELINQUISH any and all claims, rights and causes of action of every kind and nature against Prairie Grit Adaptive Sports, any co-sponsor of the Activities and their respective affiliates, subsidiaries, participants, parents, officers, directors, employees, volunteers, agents, and representatives (collectively, the "Released Parties") (including, without limitation, those for personal injury, property damage and/or wrongful death) arising (directly or indirectly) from, by virtue of or in connection with the participation of Participant in and/or Participant's attendance at the Activities. I further state and agree that all rights under 9-13- 02, N.D. Cent. Code are hereby expressly waived. I, for myself and on behalf of Participant and our respective heirs, legal representatives and successors, RELEASE the Released Parties from any liability for any of the foregoing waived and relinquished claims, rights and causes of action an COVENANT NOT TO SUE any of the Released Parties for any such claims, rights and causes of action.

I, the undersigned, do hereby grant permission to Prairie Grit Adaptive Sports to use the image and/or video of myself.Suc use includes the display, distribution, publication, transmission, or otherwise use of photographs, image, and/or video taken of myself or 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 Prairie Grit Adaptive Sports website.

By signing, / grant permission for unrestricted usage of my image and/or video to be used in print, video, and digital media. / agree that these images may be used by PGAS for a variety of purposes and that these images may be used without further notifying me