ICN Pickleball Liability Waiver

Name:

First NameLast Name

Primary Email:

example@example.com

Primary Phone Number:

Format: (000) 000-0000.

Emergency Contact Information:

First NameLast Name

Emergency Contact Phone Number:

Please provide a valid phone number to reach out in case of an emergencyFormat: (000) 000-0000.

Liability and Waiver:

Release from Liability: Recognizing that the Islamic Center of Naperville will do its best to ensure a safe experience, I understand that accidents may occur from my playing at the facility. I agree to assume these risks. By signing below, I release the ICN and the ICN Program organizers from all liability based on any damage, loss or injury whether it is the result of ordinary negligence or otherwise, caused to me by playing at ICN's facility.

Medical Treatment: I hereby give permission to be given treatment by a qualified individual. I also give permission to be transported for treatment. I further consent to the disclosure of health information and to the medical, surgical and hospital care treatment and procedures (including, but not limited to, administration of necessary anesthetics, tests, x-ray examinations, transfusions, injections, drugs) to be performed for me by a licensed physician or hospital selected by ICN if deemed immediately necessary or advisable by a physician to safeguard my health.

I have read and understand the above and have completed this form to the best of my ability. The participants will abide by all Islamic values and morals & rules. There will be a zero tolerance policy for non-compliance of any un-Islamic behavior, bullying or disrespect. Any violation of such may result in a termination of the participant from using the facility thereon.

Liability Waiver: