WAIVER OF LIABILITY & MEDICAL TREATMENT CONSENT
By signing this Liability Waiver, I hereby release KA Academy and its employees, sponsors, officers, and volunteers from any liability arising from my and my child’s participation in activities that take place during KA Programs. In the event of illness or injury, I hereby consent to whatever x-ray, examination, anesthetic, medical, surgical or dental diagnosis or treatment and hospital care are considered necessary in the best judgment of the attending licensed physician, surgeon, or dentist and performed by or under the supervision of a licensed physician or surgeon. I hereby authorize any hospital that has provided treatment to the minor(s) named on this form to surrender physical custody of such minor to KA Coaches or representative. This authorization is effective until March 20,2027 unless revoked in writing. IT IS THE INTENTION OF THE UNDERSIGNED, BY THIS INSTRUMENT, TO EXEMPT AND RELIEVE THE RELEASES FROM LIABILITY FOR PERSONAL INJURY, PROPERTY LOSS OR DAMAGE, AND WRONGFUL DEATH CAUSED BY NEGLIGENCE. The undersigned acknowledges that he/she is aware that by signing this waiver, release and indemnity Agreement, he/she KNOWINGLY AND VOLUNTARILY WAIVES ALL RIGHTS TO ASSERT ANY AND ALL CLAIMS WHATSOEVER FOR ANY PERSONAL INJURY, PROPERTY LOSS OR DAMAGE, OR WRONGFUL DEATH AGAINST THE RELEASEES.
Medical Release and Authorization
As the legal guardian of the youth athlete listed, I hereby grant permission for qualified and licensed medical professionals to diagnose and administer treatment in the event of a medical emergency. This authorization is applicable when, in the medical professional's judgment, immediate attention is necessary to prevent further harm to the minor child's life, physical appearance, physical functionality, or to alleviate undue pain, suffering, or discomfort should there be a delay in treatment.
I hereby give consent to the attending physician to undertake any necessary medical or minor surgical procedures, conduct X-ray examinations, and administer immunizations to the youth athlete named. In cases of a serious illness, the requirement for major surgery, or significant accidental injury, I am aware that the attending physician will make every reasonable effort to contact me as swiftly as possible before proceeding with treatment. This authorization is granted after a reasonable attempt has been made to reach me.
I also authorize the affiliated individuals, including Directors, Coaches, and Team Parents, to provide essential emergency treatment before the child is admitted to a medical facility.
This consent is valid during the dates and for the duration of the registered season. I willingly provide this authorization to ensure prompt medical treatment under emergency circumstances, safeguarding the life and well-being of the named minor child when I am not present.
PHOTO RELEASE
I understand that KA Academy representatives may photograph or video activities during KA programs. By signing this form, I authorize KA Academy to use on their website or publish in articles or ads any photographs or video clips taken by KA representatives that may show my or my child’s image in the context of events and activities I/we participated in at KA Academy.
WAIVER OF LAWSUIT/LIABILITY: I hereby forever release and waive my right to bring suit against KA Academy and its Board members, Directors, Managers, Officials, Trustees, Agents, employees, affiliates or other representatives in connection with exposure, infection, related to using KA ACademy programs. I understand that this waiver means I give up my right to bring any claims including for personal injuries, death, disease or property losses, or any other loss, including but not limited to claims of negligence and give up any claim I may have to seek damages, whether known or unknown, foreseen or unforeseen.
AGREEMENT TO ABIDE BY SAFETY PROTOCOLS:
I have been provided with a copy of KA Academy’s written safety protocols. I have read and I understand these safety protocols. I agree to comply -- and that my child(ren) will comply -- with the safety protocols. I acknowledge that if, at the sole discretion of KA Academies representatives, it is determined that I and/or my child(ren) are not fully complying with the safety protocols, I or my child(ren) may be precluded from further participation in KA Academy programs or activities.
I HAVE CAREFULLY READ AND FULLY UNDERSTAND ALL PROVISIONS OF THIS RELEASE AND AGREEMENT TO ABIDE BY SAFETY PROTOCOLS, AND FREELY AND KNOWINGLY ASSUME THE RISK AND WAIVE MY RIGHTS CONCERNING LIABILITY AS DESCRIBED ABOVE: