PINK OCTOBER RULES
2 on 2 Mash Up
PINK OCTOBER RULES
2 on 2 Mash Up
MID CITIES REGISTRATION PARENT/PLAYER 23
WHAT GRADE IS YOUR PLAYER
LAKE HIGHLANDS JR HIGH
WORKMAN - SAM HOUSTON
CARTER - SAM HOUSTON
FORT WORTH CHRISTIAN
SELECT YOUR TEAM THAT IS LISTED *IF TEAM IS NOT LISTED PLEASE CONTACT YOUR COACH!!
State / Province / Region
ZIP / Postal Code
ADULT X LARGE
ADULT XX LARGE
Without expectation of compensation or other remuneration, now or in the future, I hereby give my consent to [Full Court Advantage/SwinCity Mag], its affiliates and agents, to use my image/video and likeness and/or any interview statements from me in its publications, advertising or other media activities (including the Internet). This consent includes, but is not limited to:
Authorizing Full Court Advantage and its affiliates and agents to take photographs or produce videotapes, audiotapes, electronic files, or other types of media productions that capture my name, voice and/or image, to be released to members of the media, or to be used by Full Court Advantage for the purpose of:
• News media (online, print and/or broadcast)
• Websites and social media
• Publications and/or promotional materials
• Medical and/or educational training
• Closed circuit television programs
• Any other lawful purpose
The information to be disclosed includes:
•Photographic images of me
•Video or audio of me and/or my voice
(a) Permission to interview, film, photograph, tape, or otherwise make a video reproduction of me and/or record my voice;
(b) Permission to use my name; and
(c) Permission to use quotes from the interview(s) (or excerpts of such quotes), the film, photograph(s), tape(s) or reproduction(s) of me, and/or recording of my voice, in part or in whole, in its publications, in newspapers, magazines and other print media, on television, radio and electronic media (including the Internet), in theatrical media and/or in mailings for educational and awareness.
ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
I hereby assume all of the risks of participating in this THE SWINDLE GROUP LLC AND ALL ITS AFFILATES, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained or controlled by them, or because of their possible liability without fault.
I certify that I am physically fit and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in this THE SWINDLE GROUP LLC AND ALL ITS AFFILATES EVENTS. I acknowledge that this Accident Waiver and Release of Liability Form will be used by the organizers of the THE SWINDLE GROUP LLC AND ALL ITS AFFILATES EVENTS in which I may participate and that it will govern my actions and responsibilities at said THE SWINDLE GROUP LLC AND ALL ITS AFFILATES EVENTS.
In consideration of my application and permitting me to participate in this THE SWINDLE GROUP LLC AND ALL ITS AFFILATES EVENTS, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:
(A)I WAIVE, RELEASE, AND DISCHARGE from all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this THE SWINDLE GROUP LLC AND ALL ITS AFFILATES. THE FOLLOWING ENTITIES OR PERSONS: THE SWINDLE GROUP LLC AND ALL ITS AFFILATES., and/or their coaches, agents, representatives, or volunteers.
(B) I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from all liabilities or claims made because of participation in this THE SWINDLE GROUP LLC AND ALL ITS AFFILATES EVENTS, whether caused by negligence or otherwise.
I acknowledge that this THE SWINDLE GROUP LLC AND ALL ITS AFFILATES may carry with it the potential for death, serious injury, and personal loss. The risks may include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, actions of other people including, but not limited to, participants, volunteers, spectators, coaches, and lack of hydration.
I consent and agree that THE SWINDLE GROUP LLC AND ALL ITS AFFILATES., and/or their coaches, agents, representatives, or volunteers may take photographs or digital recordings of me s a participant during this event and use these in any and all media for training or promotional purposes. I further consent that my identity may be revealed therein or by description text or commentary. I waive any rights, claims or interest and I understand that there will be no financial or other remuneration.
The accident waiver, release of liability and image release shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.
I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT ON MY OWN FREE WILL.
The Undersigned parent and or natural guardian does hereby represent that he/she is, in fact, acting in such capacity, has consented to his/her child or ward’s participation in the Sports Camp, and has agreed individually and on behalf of the child or ward, to the terms of the accident waiver and release of liability set forth above. The undersigned parent or guardian further agrees to save and hold harmless and indemnify each and all parties referred to above from all liability, loss, cost, claim, or damage whatsoever which may be imposed upon said parties because of any defect on lack of such capacity to so act and release said parties on behalf of the minor and the parents or legal guardian.