Texas Premier Waiver And Release Of Liability Form printable pdf download

TEXAS PREMIER WAIVER AND RELEASE OF LIABILITY FORM

USA Volleyball - Texas Premier Volleyball Club

NOTE: This form must be read and signed before the participant is allowed to take part in any

Texas Premier training, competition, beach play, meeting, or testing sessions.

By signing this

form, the participant afﬁrms having read it.

Participant’s Name: (Please Print) __________________________________

Sponsoring Organizations USA Volleyball, Texas Premier Volleyball Club, Texas Premier training

facility, administrators, ofﬁcial agents, employees and/or coaches, staff and other representatives

of the above mentioned organizations. In consideration of my involvement under the

auspices of this sponsoring organization, I acknowledge and agree that:

1.  I risk bodily injury, including paralysis, dismemberment, and death as well as loss of or damage to property

I knowingly and freely assume all such risk; and

3.  I for myself, and on behalf of my heirs, assigns and next of kin, hereby release from liability and hold

h armless the following entities; USA Volleyball, Texas Premier Volleyball Club, Texas Premier training

f acility, administrators, ofﬁcial agents, employees and/or coaches, staff and other representatives with respect

t o any and all such injury, paralysis, dismemberment, death, and/or loss of or damage to property except that

w hich is the result of gross negligence and/or willful or wanton conduct. By signing below, I acknowledge

that I have read and understand the above conditions and have executed this waiver freely, voluntarily, and

u nderstandingly.

___________________________________

_____________________

Participant’s Signature

Date Signed (no expiration)

FOR A THLETES O F M INORITY A GE ( under a ge 1 8 a t t he < me o f r egistra<on)

This is to certify that I, as a parent/guardian of this participant, do consent to his/her release of USA Volleyball,

Texas Premier Volleyball Club, Texas Premier training facility, administrators, ofﬁcial agents, employees and/or

coaches, staff and other representatives of the above mentioned organizations from any and all liabilities incident

to his/her involvement in the programs conducted by USA Volleyball and its Regional Volleyball Associations.

We have read the above Waiver and Release, understand that we have given up substantial right by signing it and

sign it voluntarily.

___________________________________

_____________________

Participant’s Signature

Date Signed (no expiration)

___________________________________

_____________________

Parent/Guardian

Name/Relationship

___________________________________

_____________________

Parent’s Signature

Date Signed (no expiration)

Emergency Contact Phone: ________________________________________

Email Address: __________________________________________________

Texas Premier Waiver And Release Of Liability Form

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