Fillable Shooting Sports Ayssp Student/athlete Participation Form (Page 3 of 4) in pdf

cost, fee, or harm of any kind which may result from Participant’s participation in any AYSSP activity,

REGARDLESS OF WHETHER CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART

BY THE NEGLIGENCE OR FAULT OF THE RELEASED PARTIES OR OTHERWISE, AND

REGARDLESS OF WHETHER OCCURRING WHILE ON OR IN TRANSIT TO OR FROM THE

PREMISES WHERE THE ACTIVITY, OR ANY ADJUNCT TO THE ACTIVITY, OCCURS OR IS

BEING CONDUCTED.

In addition to the above, and for the same consideration previously stated, the Undersigned do HEREBY

AGREE TO INDEMNIFY, DEFEND, PROTECT AND HOLD HARMLESS the Released Parties from and

against any and all manner of claims, demands, causes of action (known or unknown), suits, liability, or

judgments of any and every kind (including attorneys’ fees) arising from any injury, death, or damage to

Participant, or to any other persons or property, caused by Participant’s participation in the AYSSP,

REGARDLESS OF WHETHER THE INJURY, DEATH, OR DAMAGE IS CAUSED BY THE

RELEASED PARTIES OR OTHERWISE.

The Undersigned hereby certify that Participant is physically and mentally fit to participate in the AYSSP and

that Participant does not have any medical record or history of conditions that could be aggravated by

participation in AYSSP activities. Upon receipt of a written request that AGFC waive such certification due to a

physical or mental impairment that substantially limits one or more of Participant’s major life activities, AGFC

may make reasonable accommodations for Participant if feasible to do so without threatening the health or

safety of others.

The Undersigned understand and agree that the Released Parties may not have medical personnel available at

the location of AYSSP activities. Unless declined immediately below, in the event of any medical emergency,

the Undersigned authorize and consent to any ambulance transportation; medical, dental, or surgical

examination, diagnosis, or treatment; and hospital care that the AGFC personnel deem necessary to obtain for

Participant’s safety and protection. (Check here ____ if the Undersigned declines to authorize and consent

to such measures in the event of any medical emergency). The Undersigned understand and agree that the

Released Parties assume no responsibility for any injury, damage, or costs which might arise out of or in

connection with such authorized emergency medical treatment.

The Undersigned agree to abide by all the rules and requirements of the AYSSP. The Undersigned further

acknowledge that the AGFC has the right to terminate Participant’s participation in the AYSSP if it is

determined that Participant’s conduct is detrimental to the best interests of the AYSSP or its participants,

Participant’s conduct violates any rule of the AYSSP, or for any other reason in the AGFC’s discretion.

The Undersigned hereby agree that this Agreement and Participant’s participation in the AYSSP shall be

construed in accordance with and governed by the laws of the State of Arkansas. The illegality, invalidity, or

unenforceability of any provision of this Agreement shall in no way affect the validity or enforceability of any

of the remainder of this Agreement, which shall be enforced to the maximum extent permitted by law. This is

the complete and binding agreement between AGFC and the Undersigned, and it supersedes all prior

understandings and/or communications, both oral and written, with respect to its subject matter.

This

Agreement cannot be terminated, rescinded, or amended, except by a written agreement signed by both AGFC

and the Undersigned.

The Undersigned acknowledge that they have fully and carefully read the terms of this Agreement and agree

thereto. This Agreement is executed on behalf of the Participant, his or her parents or guardians, their heirs,

successors, executors, administrators, and assigns.

[THE REMAINDER OF THIS PAGE IS INTENTIONALLY LEFT BLANK.]

Page 3 of 4

Shooting Sports Ayssp Student/athlete Participation Form Page 3

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