Strikers Field Hockey Club
PARTICIPANT AGREEMENT, RELEASE AND ACKNOWLEDGMENT FORM
In consideration of the services of the Strikers Field
Hockey Club/Cecil County Parks and Recreation (Strikers),
their officers, agents, volunteers, participants, employees, and all other
persons or entities acting in any capacity on their behalf, I hereby agree to
release and discharge Strikers, on behalf of myself, my children, my parents, my
heirs, assigns, personal representatives and estate as follows:
1. I acknowledge that Field Hockey entails known and anticipated risks which
could result in physical or emotional injury, paralysis, or damage to myself, to
property, or to third parties. I understand that such risks simply can not be
eliminated without jeopardizing the essential qualities of the activity.
The risks include, among other things; colliding with another
player or players, walls, or barriers; falling or tripping onto the floor,
barrier or other persons; getting hit by a stick, ball, or person.
Furthermore, Strikers employees and volunteers have difficult
jobs to perform. They seek safety, but they are not infallible. They might be
ignorant of a participant’s physical fitness or abilities. They may give
inadequate warnings or instructions, and the equipment being used might
malfunction.
2. I expressly agree and promise to accept and assume all the risks existing in
this activity. My participation in this activity is purely voluntary, and I
elect to participate in spite of the risks.
3. I hereby voluntarily release, forever discharge, and agree to indemnify and
hold harmless Strikers from any and all claims, demands, or causes of action,
which are in any way connected with my participation in this activity or my use
of Strikers equipment or facilities, including any such claims which allege
negligent acts or omissions of Strikers.
4. Should Strikers or anyone acting on their behalf be required to incur
attorney’s fees and costs to enforce this agreement, I agree to indemnify and
hold harmless them for all such fees and costs.
5. I certify that I have adequate insurance to cover any injury or damage I may
cause or suffer while participating, or else I agree to bear the costs of such
injury or damage myself. I further certify that I have no medical or physical
conditions which could interfere with my safety in this activity, or else I am
willing to assume, and bear the costs of all risks that may be created, directly
or indirectly, by any condition.
By signing this document, I acknowledge that if I or anyone
else is hurt or property is damaged during my participation in this activity, I
may be found by a court of law to have waived my right to maintain a lawsuit or
claim against Strikers on the basis from which I have released them herein.
I have had sufficient opportunity to read this entire
document. I have read and understand it, and I agree to be bound by its terms.
Signature of Participant:
Print Name:
Address with city and state:
Phone:
Date:
PARENT’S OR GUARDIAN’S ADDITIONAL INDEMNIFICATION
( must be completed for participants under the age of 18)
In consideration of
(print minor’s name) (“Minor”) being permitted by Strikers to participate
in its activities and to use its equipment and facilities, I further agree to
indemnify and hold harmless Strikers from any and all claims which are brought
by, on behalf of Minor, and which are in any way connected with such use or
participation by Minor.
Parent or Guardian Signature:
Print Parent Name:
Date:
Name of team/club