ADULT MEDICAL RELEASE & WAIVER OF LIABILITY
2024 Turkey Shootout
MEDICAL RELEASE
Name of Player
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First Name
Last Name
Date of Birth of Player
*
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Month
-
Day
Year
Date
Type of Known Allergies (including allergies to medicines)
*
Any other medical problems/issues that should be noted
*
Family Physician
*
Phone Number of Physician
*
Please enter a valid phone number.
Insurance Carrier
*
Name of Parent/Guardian
*
First Name
Last Name
Phone Number of Parent/Guardian
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number of Parent/Guardian
*
Please enter a valid phone number.
WAIVER OF LIABILITY
In consideration of the risk of injury that exists while participating in the 2024 Turkey Shootout (hereinafter the “Event”); and In consideration of my desire to participate in said Event and benign given the right to participate in same; I hereby, for myself, my heirs, executors, administrators, assigns, or personal representatives (hereinafter collectively, “Releasor,” “I” or “me”, which terms shall also include Releasor’s parents or guardian if Releasor is under 18 years of age), knowingly and voluntarily enter into this Waiver and Release of Liability and hereby waive any and all rights, claims or causes of action of any kind arising out of my participation in the Event; and I hereby release and forever discharge FCTR Sports, located at 4145 Beltline Road #212, Addison, Texas 75001, their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns (collectively “Releasees”), from any physical or psychological injury that I may suffer as a direct result of my participation in the aforementioned Event. I am voluntarily participating in the aforementioned activity and I am participating in the Event entirely at my own risk. I am aware of the risks associated with participating in this Event, which may include, but are not limited to: physical or psychological injury, pain, suffering, illness, disfigurement, temporary or permanent disability (including paralysis), economic or emotional loss, and death. I understand that these injuries or outcomes may arise from my own or others’ negligence, conditions related to travel to and from the event, or from conditions at the event location(s). Nonetheless, I assume all related risks, both known and unknown to me, of my participation in this event. I further agree to indemnify, defend and hold harmless the Releasees against any and all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf, including attorney’s fees and any related costs. I further acknowledge that Releasees are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf of Releasees. In the event that I should require medical care or treatment, I authorize FCTR Sports to provide all emergency medical care deemed necessary, including but not limited to, first aid, CPR, the use of AEDs, emergency medical transport, and sharing of medical information with medical personnel. I further agree to assume all costs involved and agree to be financially responsible for any costs incurred as a result of such treatment. I am aware and understand that I should carry my own health insurance. I further acknowledge that this Event may involve a test of a person’s physical and mental limits and may carry with it the potential for death, serious injury, and property loss. I agree not to participate in the Event unless I am medically able and properly trained, and I agree to abide by the decision of the FCTR Sports official or agent, regarding my approval to participate in the Event. I hereby acknowledge that I have carefully read this “Waiver and Release” and fully understand that it is a release of liability. I expressly agree to release and discharge FCTR Sports and all of its affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns, form any and all claims or causes of action and I agree to voluntarily give up or waive any right that I otherwise have to bring a legal action against FCTR Sports for personal injury or property damage. To the extent that the statute or case law does not prohibit releases for ordinary negligence, this release is also for such negligence on the part of FCTR Sports, its agents, and employees. I agree that this release shall be governed for all purposes by Texas law, without regard to any conflict of law principles. This release supersedes any and all previous oral or written promises or other agreements. In the event that any damage to equipment or facilities occurs as a result of my or my family’s or my agent’s willful actions, neglect or recklessness, I acknowledge and agree to be held liable for any and all costs associated with any such actions or neglect or recklessness.This Waiver and Release of Liability shall remain in effect for the duration of my participation in the Event, during this initial and all subsequent events or participation. This agreement was entered into at arm’s-length, without duress or coercion, and is to be interpreted as an agreement between two parties of equal bargaining strength. Both Releasor and FCTR Sports agree that this agreement is clear and ambiguous as to its terms, and that no other evidence shall be used or admitted to alter or explain the terms of this agreement, but that it will be interpreted based on the language in accordance with the purposes for which it is entered into. In the event that any provision contained within this Release of Liability shall be deemed to be severable or invalid, or if any term, condition, phrase or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this agreement shall remain in full force and effect. If a court should find that any provision of this agreement to be invalid or unenforceable, but that by limiting said provision it would become valid and enforceable, then said provision shall be deemed to be written, construed and enforced as so limited.
In the event of an emergency, please contact the following person(s) in the order presented:
Name of Emergency Contact #1
*
First Name
Last Name
Name of Emergency Contact #2
*
First Name
Last Name
Name of Emergency Contact #3
First Name
Last Name
Name of Player Participant
*
First Name
Last Name
Signature
*
Date
*
-
Month
-
Day
Year
Date
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