NSi Field House Waiver
NSi Field House Waiver
Please complete the following waiver form for participating in the NSi Field House activities.In consideration of my participation at NSi Field House, I hereby forever release and covenant not-to-sue NSi Field House, and any of their employees, coaches, trainers, volunteers, instructors and all others involved, from any and all present and future claims resulting from ordinary negligence on the part of NSi Field House or others listed for property damage, personal injury, or wrongful death, arising as a result from my engaging in or receiving instruction in activities incidental thereto, wherever, whenever, or however the same may occur.I hereby voluntarily waive any and all claims both present and future, resulting from ordinary negligence, that may be made by me, my family, estate, heirs, or assigns, and I relinquish on behalf of myself, spouse, heirs, estate and assigns the right to recover for injury or death.I am aware that participation in lessons or team sports at NSi Field House are vigorous team activities that can involve severe cardiovascular stress and violent physical contact. I understand that participation in activities here can involve certain risks, including but not limited to death, serious neck and spinal injuries resulting in complete or partial paralysis, brain damage, and serious injury to virtually all bones, joints, muscles, and internal organs, and that equipment provided for my protection may be inadequate to prevent serious injury. In addition, I understand that participation in sports and activities involve potential incidents thereto, including, but not limited to, travel to and from the site of activity, participation at sites that may be remote from available medical assistance, and the possibility of reckless conduct from other participants. I am voluntarily participating in this activity with knowledge of the danger involved and hereby agree to accept any and all risks of property damage, personal injury or death. __________ I further agree to indemnify and hold harmless NSi Field House and others listed for any and all claims arising as a result of my participation in club sports or activities incidental thereto, wherever, whenever, or however the same may occur.I understand that this waiver is intended to be as broad and inclusive as permitted by the laws of theState of Florida, and I agree that if any portion of is held invalid, the remainder of the waiver will continue in full legal force and effect. I further agree that the venue for any legal proceedings shall be in the State of Florida. I affirm that I am of legal age and am freely signing this agreement. I have read this form and fully understand that, by signing this form, I am giving up legal rights and/or remedies which may be available tome for the ordinary negligence of NSi Field House or any of the parties listed above.
Participants Name
First Name
Last Name
Parents Name
First Name
Last Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth
-
Month
-
Day
Year
Date
Emergency Contact Name
First Name
Last Name
Emergency Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Do you understand and accept the risks involved in the NSi Field House activities?
Yes
No
Do you agree to follow the safety guidelines and instructions provided by the staff?
Yes
No
Do you understand and accept the risks involved in the NSi Field House activities?
Yes
No
Submit
Should be Empty: