Liability Release Form AWS

Liability Release Form Between Omaha Junior Eagles Inc., and River City Youth Authority Inc., further referred to as “Organizations” and Participant Name (further referred to as “Participant”): ______________________________________ As the parent or legal guardian of the Participant, I hereby release from all liability and hold harmless the Organizations and any employee, volunteer, board member or representatives of the Organizations. I am aware of the risks of participation. I hereby state that Participant is in sufficient physical condition to accept a rigorous level of physical activity. I understand that a physician’s examination is not required for registration. Due to the strenuous nature of the activities, it is advisable that the Participant and parents/guardian consult with a physician before participation. I understand that participation in this program is strictly voluntary and I freely chose to participate. I assume all risk and hazards incidental to such participation, including transportation to and from activities. I understand that the Organizations do not provide medical coverage, and I will be responsible for any medical costs I incur as a result of participation. In the event that my child becomes ill or is injured, I hereby authorize and give my consent to whatever medical care and/or services, including emergency transportation, deemed necessary under the circumstances. I agree to be financially responsible for the cost of such assistance and/or treatment. I understand that the Organizations will attempt to notify me as soon as possible. I hereby grant authorization to the Organizations to use, copyright, and/or publish photographs/digital images of myself, or the program participant(s) in materials promoting the Organization programs including but not limited to the Omaha Junior Eagles website, flyers, and YouTube. I realize that it is not possible for the Organizations to control access to its website, and I will not hold the Organizations liable or responsible for unauthorized access or use of my child’s or my image. I agree that as the parent or legal guardian I am solely responsible for determining if any issued, loaned or gifted equipment is safe for my child’s use. I understand that The Organizations serve only as a conduit to help provide used equipment to players. I understand The Organizations make no claims as to the safety or effectiveness of this equipment, and they hold no liability if the equipment fails to provide the level of safety or effectiveness that is expected or desired. The undersigned does hereby further agree to abide by all the rules and regulations that are presented by the Organizations. I have read the above release, and I am fully familiar with the contents and consequences of it. This release shall be binding upon me and my heirs, legal representatives, and assignees.

__________________________________________________________ _______________________ Printed Name of Parent or Legal Guardian Signature of Parent or Legal Guardian Date

EMAIL Address: _______________________________________________________________ Contact Phone #: ______________________________________________________________ Participant Address: ___________________________________________________________

Omaha Junior Eagles Inc.

ver2016.1