RELEASE AND WAIVER OF LIABILITY,
INDEMNITY AND PARENTAL CONSENT AGREEMENT
IN CONSIDERATION of being permitted to participate in any way at Star Haven Associates, Inc. (D/B/A DIAMOND SPORTS CLUB) activity ("Activity") I, the signer below, for myself, for personal representatives, assigns, heirs, and next of kin now declare:
- ACKNOWLEDGE, agree, and state that I understand the nature of DIAMOND SPORTS CLUB Activities and that I am qualified, in good health, and in proper physical condition to participate in such Activity. I further agree and warrant that if at any time I believe conditions to be unsafe, I will immediately discontinue further participation in the Activity.
- FULLY UNDERSTAND THAT: (a) DIAMOND SPORTS CLUB ACTIVITIES INVOLVE RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS, AND DEATH ("RISKS"); (b) these Risks and dangers may be caused by my own actions or inactions, the actions or inactions of others participating in the Activity, the condition in which the Activity takes place, or THE NEGLIGENCE OF THE "RELEASEES" NAMED BELOW; (c) there may be OTHER RISK AND SOCIAL AND ECONOMIC LOSSES either not known to me or not readily foreseeable at this time; and I FULLY ACCEPT SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I might incur as a result of my participation or that of the minor in the Activity.
- HEREBY RELEASE, DISCHARGE, AND AGREE AND PROMISE NOT TO SUE DIAMOND SPORTS CLUB, their respective administrators, directors, agents, officers, members, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owner and lessors of premises on which the Activity takes place, (each considered one of the "RELEASEES" herein) FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON MY ACCOUNT THAT ARE CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE "RELEASEES" OR OTHERWISE, INCLUDING NEGLIGENT MEDICAL ASSISTANCE RESCUE OPERATIONS AND I FURTHER AGREE that if, despite this RELEASE AND WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT I, or anyone on my behalf, makes a claim against any of the Releasees, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES from any litigation expenses, attorney fees, loss, liability, damage, or cost which may incur as the result of such claim.
I have read this agreement, fully understand its terms, understand that I have given up substantial rights by signing it and have signed it freely and without inducement or assurance of any nature. I intend this agreement to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid or unenforceable the balance, notwithstanding, shall continue in full force and effect.
And I, the minor's parent and/or legal guardian, understand the nature of Diamond Sports Club Activities and the Minor's experience and capabilities, and I believe the minor to be qualified, in good health, and in proper physical condition to participate in such acivity. I herby release, discharge, agree and promise not to sue, and agree to indemnify and save and hold harmless each of the releasees from all liability claims, demands, losses, or damages on the minor's account caused or alleged to be caused in whole or in part by the negligence of the "releasees" or otherwise, including negligent medical assistance or rescue operation and further agree that if, despite this release, I, the minor, or anyone on the minor's behalf makes a claim against any of the releasees named above, I will indemnify, save, and hold harmless each of the releasees from any litigation expenses, attorney fees, loss liability, damage, or cost any may incur as the result of any such claim.
RECOMMENDED CONCUSSION &
HEAD INJURY INFORMATION RELEASE
This form must be signed by all participants and parent/guardians before they participate in any activities at Diamond Sports Club.
A concussion is a brain injury and all brain injuries are serious. They are caused by a bump, blow, or jolt to the head, or by a blow to another part of the body with the force transmitted to the head. They can range from mild to severe and can disrupt the way the brain normally works. Even though most concussions are mild, all concussions are potentially serious and may result in complications including prolonged brain damage and death if not recognized and managed properly. In other words, even a “ding” or a bump on the head can be serious. You can’t see a concussion and most sports concussions occur without loss of consciousness. Signs and symptoms of concussion may show up right after the injury or can take hours or days to fully appear. If your child reports any symptoms of concussion, or if you notice the symptoms or signs of concussion yourself, seek medical attention right away.
Symptoms may include one or more of the following*
Headaches; “Pressure in head”; Nausea or vomiting; Neck pain; Balance problems or dizziness; Blurred, double, or fuzzy vision; Sensitivity to light or noise; Feeling sluggish or slowed down; Feeling foggy or groggy; Drowsiness; Change in sleep patterns; Amnesia; “Don’t feel right”; Fatigue or low energy; Sadness; Nervousness or anxiety; Irritability; More emotional; Confusion; Concentration or memory problems (forgetting game plays); Repeating the same question/comment
Signs observed by teammates, parents, and coaches include*
Appears dazed; Vacant facial expression; Confused about assignment; Forgets plays; Is unsure of game, score, or opponent; Moves clumsily or displays incoordination; Answers questions slowly; Slurred speech; Shows behavior or personality changes; Can’t recall events prior to hit; Can’t recall events after hit; Seizures or convulsions; Any change in typical behavior or personality; Loses consciousness
*(Adapted from the CDC and the 3rd International Conference in Sport)
What can happen if my child keeps on playing with a concussion or returns too soon?
Athletes with the signs and symptoms of concussion should be removed from play immediately. Continuing to play with the signs and symptoms of a concussion leaves the young athlete especially vulnerable to greater injury. There is an increased risk of significant damage from a concussion for a period of time after that concussion occurs, particularly if the athlete suffers another concussion before completely recovering from the first one (second impact syndrome). This can lead to prolonged recovery, or even to severe brain swelling with devastating and even fatal consequences. It is wellknown that adolescent or teenage athletes will often under report symptoms of injuries. And concussions are no different. As a result, coaches and parents are the key for athlete’s safety.
If you think your child has suffered a concussion
Any athlete even suspected of suffering a concussion should be removed from the game or practice immediately. No athlete may return to activity after sustaining a concussion, regardless of how mild it seems or how quickly symptoms clear, without written medical clearance from a Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO). Close observation of the athlete should continue for several hours. You should also inform your child’s coach if you think that your child may have a concussion Remember it is better to miss one game than miss the whole season. When in doubt, the athlete sits out!
Cognitive Rest & Return to Learn
The first step to concussion recovery is cognitive rest. This is essential for the brain to heal. Activities that require concentration and attention such as trying to meet academic requirements, the use of electronic devices (computers, tablets, video games, texting, etc.), and exposure to loud noises may worsen symptoms and delay recovery. Students may need their academic workload modified while they are initially recovering from a concussion. Decreasing stress on the brain early on after a concussion may lessen symptoms and shorten the recovery time. This may involve staying home from school for a few days, followed by a lightened school schedule, gradually increasing to normal. Any academic modifications should be coordinated jointly between the student’s medical providers and school personnel. No consideration should be given to returning to physical activity until the student is fully integrated back into the classroom setting and is symptom free. Rarely, a student will be diagnosed with post-concussive syndrome and have symptoms that last weeks to months. In these cases, a student may be recommended to start a non-contact physical activity regimen, but this will only be done under the direct supervision of a healthcare provider.
Return to Practice and Competition
The CDC states that if an athlete suffers, or is suspected of having suffered, a concussion or head injury during a competition or practice, the athlete must be immediately removed from the competition or practice and cannot return to practice or competition until a Health Care Professional has evaluated the athlete and provided a written authorization to return to practice and competition. The CDC recommends that an athlete not return to practice or competition the same day the athlete suffers or is suspected of suffering a concussion. The CDC also recommends that an athlete’s return to practice and competition should follow a graduated protocol under the supervision of the health care provider (MD or DO).
For current and up-to-date information on concussions you can go to:
January 18, 2020