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MTA Waiver and Release of Liability + Content and Media Release

1. ACKNOWLEDGMENT OF RISKS


I understand that participation in team and individual trainings, games and related physical activities involves inherent risks, including but not limited to:


Falls, collisions, and contact with other participants


Equipment-related injuries


Overexertion or physical strain


Serious injuries such as sprains, fractures, concussions, Paralysis, or death


I acknowledge that while coaches and staff take reasonable precautions to provide a safe environment, the risk of injury cannot be eliminated.


2. ASSUMPTION OF RISK


I knowingly and voluntarily assume all risks, both known and unknown, related to my child's participation in the activities/drills offered by MindTap Athletics. This includes risks that may arise from the actions, negligence, or carelessness of the organization, its coaches, staff, volunteers, participants, or others present at activities.


3. RELEASE OF LIABILITY


To the fullest extent permitted by California law, I, on behalf of myself and the minor participant, release and hold harmless the following parties:


-The organization (MindTap Athletics), Its owners, staff, volunteers, and contractors


-Facility owners or field operators where activities take place


-Team operators


From any and all claims, liabilities, damages, or expenses arising out of or related to the minor's participation in training sessions, games, or any activities done outside of MTA services time


This release includes claims arising from ordinary negligence, but does not apply to gross negligence or willful misconduct as prohibited by California law.


4. AGREEMENT TO FOLLOW RULES


The participant and parent/ guardian agree to:


-Follow all instructions provided by coaches and staff


-Follow safety rules and training guidelines


-Inform staff of any injuries, medical conditions, or safety concerns that occur in or outside of trainings


If a participant observes any unusual hazard or unsafe condition, they agree to stop participation and notify a coach or staff member immediately


5. MEDICAL AUTHORIZATION & EMERGENCY CARE


I certify that my child is physically able to participate in sports training activities


In the event of an injury or medical emergency, I authorize MindTap Athletics, Its staff or personnel to:


-Provide basic first aid


-Arrange transportation to a medical facility


-Seek emergency medical treatment if necessary


I understand that I am fully financially responsible for any medical expenses incurred


6. MEDICAL INFORMATION


7. INSURANCE ACKNOWLEDGMENT


I understand that MindTap Athletics may carry general liability insurance, but that this does NOT replace personal medical insurance.


I agree that it is my responsibility to maintain health insurance coverage for the participant.


8. GOVERNING LAW


This agreement shall be governed by the laws of the State of California. Any disputes arising from this agreement shall be held in Los Angeles, California, or in the appropriate courts within California.


I CERTIFY THAT I AM THE LEGAL PARENT OR GUARDIAN OF THE PARTICIPANT LISTED ABOVE. 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.

First Participant's Name
First Name*
Middle Name
Last Name*
Phone*
First Participant's Date of Birth*
Date of Birth
Medical Information
Known Medical Conditions/ Allergies
Medications
First Participant's Signature*
Second Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Medical Information
Known Medical Conditions/ Allergies
Medications
Third Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Medical Information
Known Medical Conditions/ Allergies
Medications
Fourth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Medical Information
Known Medical Conditions/ Allergies
Medications
Fifth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Medical Information
Known Medical Conditions/ Allergies
Medications
Sixth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Medical Information
Known Medical Conditions/ Allergies
Medications
Seventh Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Medical Information
Known Medical Conditions/ Allergies
Medications
Eighth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Medical Information
Known Medical Conditions/ Allergies
Medications
Ninth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Medical Information
Known Medical Conditions/ Allergies
Medications
Tenth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Medical Information
Known Medical Conditions/ Allergies
Medications
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
Program
Which program is this waiver for?*
Emergency Contact
Name
Relationship to Athlete
Phone number
Photo & Video Release

I grant permission for MindTap Athletics to photograph or record video of the participant during training sessions, games, or events.

I allow MindTap Athletics to use photo and video content of participant*
No
Yes
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*
Middle Name
Last Name*
Phone*
Parent or Guardian's Date of Birth*
Date of Birth
Medical Information
Known Medical Conditions/ Allergies
Medications
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.


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