Cowlitz Flag Registration


Waiver of Liability, Release
Assumption of Risk & Indemnity Agreement
For and in consideration of the undersigned participant's registration with Cowlitz Flag Football being allowed to participate in events and member activities, participant and the parent(s) or legal guardian(s) of participant waive, release and relinquish any and all claims for liability and cause(s) of action, including for personal injury, property damage or wrongful death occurring to participant or participant’s parent(s) or legal guardian(s) arising out of participation in Camp events, the sport of flag football, and/or activities incidental thereto, whenever or however they occur and for such period said activities may continue, and by this agreement any such claims, rights, and causes of action that participant and/or participant's parent(s) or legal guardian(s) may have are hereby waived, released and relinquished, and participant and participant’s parent(s)/guardian(s) do so on behalf of their heirs, executors, administrators and assigns.
Participant and participant's parent(s)/guardian(s) acknowledge, understand and assume all risks relating to sports participation and activities incidental thereto, and understand that sports and activities incidental thereto involve risks to participant's and participant's parent('s)/guardian('s) person including bodily injury, partial or total disability, paralysis and death, and damages which may arise there from and that we have full knowledge of said risks. These risks and dangers may be caused by the negligence of the participant, participant's parent(s)/guardian(s)or the negligence of others, including the organization, its affiliates, members, event hosts, other participants, other parents and legal guardians, coaches, officials, sponsors, advertisers, owners and operators of the premises used to conduct any event and each of them, their officers, directors, agents and employees (collectively, "releasees"), and include risks arising from the conditions and use of sports facilities and related premises. I/We further acknowledge that there may be risks and dangers not known to us or not reasonably foreseeable at this time.
Participant and participant's parent(s)/guardian(s) acknowledge, understand and assume the risks, if any, arising from the conditions and use of sports facilities and related premises, whether as a participant or a spectator, including without limitation, the risks involved with participating in the Organization’s sports activies. Participant and participant's parent(s)/guardian(s) further acknowledge and understand that included within the scope of this waiver and release is any cause of action (including any cause of action based on negligence) arising from the performance, or failure to perform, maintenance, inspection, supervision or control of said areas and for the failure to warn of dangerous conditions existing at said facilities, for negligent selection of certain releasees, or negligent supervision or instruction by releasees.
Participant and participant's parent(s)/guardian(s) agree if any claim for personal injury or wrongful death is commenced against releasees, he/she shall defend, indemnify and save harmless from any and all claims or causes of action by whomever or wherever made or presented for his/her personal injuries, property damage or wrongful death.
Participant and participant's parent(s)/guardian(s) acknowledge that they have been provided and have read the above paragraphs and have not relied upon any representations of releasees, that they are fully advised of the potential dangers of flag football and understand these waivers and releases are necessary to allow the activities of the Organization to exist in its present form.

Parent or Guardian Signature (if under 18) Date Signed
Gagliardi Insurance Services – CA License # 0791300 – Amateur Sports Application. Updated 2/2017. Supersedes all previous applications.

 

* indicates required fields


 
Payments Accepted By

Note: Credit Card information can be entered once this form is submitted