Loading...

Lefty's Sports Academy

Participation - Release Form

June 2020 - August 2021

Today's Date: April 15, 2024

Adult and Minor Participant Waiver/Release/Assumption of Risk/Agreement

  THIS WAIVER NEEDS ONLY TO BE COMPLETED ONCE

JUNE 15, 2020 THROUGH AUGUST 31,  2021

 

In consideration of participating in any way in the athletics/sports programs, and /or participating in or attending related events or activities, offered by Lefty’s Sport Academy, Inc., during the period between June 15, 2020 and August 31, 2021, the undersigned:

1.  Agrees to observe and obey all posted rules and warnings and further agrees to follow any oral instructions given by Lefty’s Sports Academy, Inc., its employees, coaches, representatives, or agents of Lefty’s Sports Academy, Inc.

2.  Acknowledges and fully understands that each participant will be engaging in activities that involve risk of serious injury, including permanent disability and/or death, and that severe social and economic loss may result not only from his or her own actions, inactions, or negligence, but from the actions, inactions or negligence of others, as well as the rules of play, the condition of the premises or from any equipment used.  Further that there may be other risks not known to the adult and/or minor participant including risks that may not be reasonably foreseeable.

3. Assumes all of the foregoing risks and accepts personal responsibility for any injury, disability or death, and any damages, whether social or economic while on premise.

4. Agrees that he or she, or the parent(s) or legal guardian(s) of the minor participant understand and/or will instruct the minor participant, that prior to participating he or she shall inspect the facilities and equipment to be used, and if the participant believes anything is unsafe, he or she shall immediately inform his or her coach, supervisor or Lefty’s Sports Academy, Inc., Staff of such condition(s) and refuse to participate unless and until such condition(s) is cured or removed.

5. Represents that I, or my child, am qualified, in good health and in proper physical condition to participate in activity(ies) sponsored by / at Lefty’s Sports Academy, Inc., and hereby authorize any representative of Lefty’s Sports Academy, Inc., or medical provider, to seek medical attention on my behalf. Or on the behalf of my child, to ensure my well being, or the well being of my child, without any legal liability whatsoever, inclusive of any responsibility of, or any negligent rescue operations. I certify that I currently have medical/health insurance to cover any injuries that I may sustain during my participation in activities at Lefty’s Sports Academy, Inc.

6.  Releases, waves, discharges and covenants not to sue Lefty’s Sports Academy, Inc., its affiliated clubs, administrators, members, directors, officers, agents, coaches, and other employees or volunteers of Lefty’s Sports Academy, Inc., other participants, sponsoring agencies, sponsors, manufacturers, advertisers, and if applicable, owners and lessors/lessees of the premises used to conduct the event or activity in which I, or the minor participant for whom I am responsible, participate (all of which are hereinafter referred to as “releases”), from any and all liability to each of the undersigned, his or her heirs and the next of kin, for any and all claims, demands, or losses or damages on account of any injury, including death or damage to property, caused or alleged to have been caused, in  whole or in part, by the releases or otherwise.

7.  I hereby authorize Lefty’s Sports Academy, Inc., to utilize in any promotional materials any photographic image or video taken of me, or my child, while participating in any activity at or sponsored by Lefty’s Sports Academy, Inc.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

 

WAIVER/RELEASE FOR COMMUNICABLE DISEASES INCLUDING COVID-19

ASSUMPTION OF RISK / WAIVER OF LIABILITY / IMDEMNIFICATION AGREEEMENT

 

In consideration of being allowed to participate on behalf of Lefty’s Sports Academy’s athletic program and related events and activities, the undersigned acknowledges, appreciates, and agrees that:

1. Participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, Influenza, and COVID-19.  While particular rules and personal discipline may reduce this risk, the risk of serous illness and death does exist; and,

2.  I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and

3. I willingly agree to comply with the stated and customary terms and conditions for participation as regards protection against infectious diseases.  If, however, I observe any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and

4.  I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS , LEFTY’S SPORTS ACADEMY, INC.,  their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event/activity (“RELEASEES”), WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

 

FOR PARTICIPANTS OF MINORITY AGE (UNDER 18 AT THE TIME OF REGISTRATION)

This is to certify that I, as parent/guardian, with legal responsibility for this participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of presence and participation and his/her personal responsibilities for adhering to the rules and regulations for protection against communicable diseases.  Furthermore, my child/ward understands and accepts these risks and responsibilities.  I for myself, my spouse, and child/ward do release and agree to indemnity and hold harmless the Releasees for any and all liabilities incident to my minor child’s/ward’s presence or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent provided by law.

 

 

April 15, 2024

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Reason for Signing the Waiver:
Please check the reason(s) for Signing the Waiver: This does not limit your participation in other events/activities. Your signature consents to participation in all activities offered by Lefty's Sports Academy. *
Use the Batting Cages
Camps, Clinics or Lessons
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!