Waiver & Medical Release
Please enter me in the Mass Barbell Summer Open weightlifting competition to be held on Saturday, August 24, 2019, at Mass Barbell, Mass Barbell LLC, West Boylston, MA. I certify that I am an amateur in good standing and a current member of USA Weightlifting. In consideration of my entry into the competition, I do hereby waive and release the IWF, USA Weightlifting, and its New England LWC, Local Organizing Committee, Mass Barbell LLC, Mass Barbell, the Mass Barbell team, its coaches, officers, agents, the meet director, competition personnel, volunteers, otherwise listed as the organizers, and all other related parties from any and all actions, liability, claims and demands of every kind and nature that I or my heirs or personal representatives may have for bodily injury, for expenses of medical treatment, hospitalization and other costs, damages, or losses suffered or incurred by me in connection with my travel to and from the meet and my participation in the competition and related.
Activities: except that the foregoing waiver and release shall not apply to injuries, damages, and loss resulting from gross negligence or intentional misconduct of the IWF, USA Weightlifting or its New England LWC or bodily injuries or medical expenses covered by accidental death, dismemberment and/or loss of sight and medical reimbursement insurance policies maintained by USA Weightlifting
I agree to be photographed and filmed under conditions approved and authorized by the IWF, USA Weightlifting, or its New England LWC to include use of my name, biographical information, public appearances, interviews, photographs, portrait and motion pictures and television recordings of my weightlifting performance and grant to the IWF, USA Weightlifting, Mass Barbell, Mass Barbell LLC, or its New England LWC the right to record and make use of the same, and to authorize others to do so in promoting the competition and the success of the weightlifting team on which I compete, to promote the image of the IWF, USA.
I agree that the organizers may make judgments with appropriate input from available medical personnel as to my treatment hospitalization or other medical care in the event of my illness or accidental injury in connection to my participation in the competition should I be disabled or incompetent to make necessary and appropriate decisions concerning such treatment, hospitalization or other care. I authorize the IWF, USA Weightlifting or its New England LWC, and its agents (including competition personnel and volunteers) to make decisions for me as though they stood in a relationship to me of parent, guardian, or next of kin should circumstances require the aforementioned to make judgments and provide that my next of kin cannot be timely and/or conveniently contacted to participate in the making of such judgments.
I hereby release and agree to hold the Organizers harmless from all expenses, causes of action, liability, claims, demands arising from good faith judgments made by the Organizers concerning my treatment, hospitalization and medical care in the event of my illness, injury or other emergency circumstances in connection with the completion. I agree that I will be financially responsible for treatment, hospitalization and other medical care received by me in the event of my illness, injury or other emergency circumstances in connection with the competition, except in the extent of my injuries and medical expenses, if any, are covered by accidental death, dismemberment, loss of sight, and medical reimbursement insurance policies: in which event, I will nevertheless continue to be financially responsible for expenses of treatment, hospitalizations and other medical care in excess of such policies’ limits.
I am aware that schedule changes may take place and I am responsible to seek such changes via the website at www.massbarbellgym.com and/or Instagram, Facebook, Twitter, Mass Barbell Events. Mass Barbell, Mass Barbell LLC is a private facility and reserves the right to decline any applicant. All entries are final and no refunds will be granted for any circumstance.