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North Dakota Elite, LLC
RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT

 

THIS IS AN IMPORTANT LEGAL DOCUMENT. READ CAREFULLY BEFORE
SIGNING.


I acknowledge that an individual who participates in the North Dakota Elite, LLC (ND Elite) program accepts and assumes the inherent risks of participation in the program. I attest and verify that I am physically fit and I have sufficiently trained for ND Elite, and that a medical doctor has verified my physical condition. In consideration of my being permitted to participate in the program, I agree to ASSUME ANY AND ALL RISKS OF INJURY OR DEATH, which may be associated with or result from my participation in these events.

In consideration of acceptance of my entry into ND Elite, I, for myself, my heirs, my executors, my administrators, my trustees, and any and all successors in interest, do hereby voluntarily and knowingly agree to forever waive and release any and all rights and claims for any injuries and damages, including but not limited to demands or actions for negligence, premises liability, emotional injury, intentional conduct, resulting in unintended injury or damage tort claims, any other actions or demands of whatsoever nature, to the fullest extent permitted by law, I may have against (1) North Dakota Elite,LLC ; (2) Chelsea Hermanson; (3) Brad Hartsoch;and (4) all employees, principals,directors, shareholders, agents, members, managers, affiliates, volunteers, officials, and representatives acting for or on behalf of any of these entities (“Releasees”) in connection with my participation in the ND Elite program.

 I further agree that if, despite this release, waiver of liability, and assumption of risk I, or anyone on my behalf, makes a claim against any of the Releasees, I will indemnify, save, and hold harmless each of Releasees from any loss, liability, damage, or cost which may incur as a result of such claim. 

As a condition of my participation in this Event, I hereby grant ND Elite a limited license to use my name, likeness, image, voice, video, athletic performance, biographical and other information (collectively, “Likeness”), in any format whatsoever, and to distribute, broadcast and exhibit these without charge, restriction or liability, but only for the purposes of advertising or promoting the gym, ND Elite, or the sport of Athletics. The foregoing grant, however, does not constitute consent to use my Likeness in an endorsement of any product or service without my specific written consent.

I have read this RELEASE AND WAIVER OR LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT, understand that I have given up substantial legal rights by signing it and have signed it freely and without any inducement and assurance of any nature and intend it 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 the balance, notwithstanding, shall continue in full force and effect. I hereby further agree that this Agreement shall be construed in accordance with the laws of the State of North Dakota.

Dated: Updated April 2019

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Second Participant's Date of Birth*
Second Participant's Signature*
Third Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Third Participant's Date of Birth*
Third Participant's Signature*
Fourth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Fourth Participant's Date of Birth*
Fourth Participant's Signature*
Fifth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Fifth Participant's Date of Birth*
Fifth Participant's Signature*
Sixth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Sixth Participant's Date of Birth*
Sixth Participant's Signature*
Seventh Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Seventh Participant's Date of Birth*
Seventh Participant's Signature*
Eighth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Eighth Participant's Date of Birth*
Eighth Participant's Signature*
Ninth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Ninth Participant's Date of Birth*
Ninth Participant's Signature*
Tenth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Tenth Participant's Date of Birth*
Tenth Participant's Signature*
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*
ndelitecheer@outlook.com
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
PARENTAL CONSENT (required only if under age 18) I, the minor's parent and /or legal guardian, understand the nature of the above referenced Activity and the minor's experience and capabilities and believe the minor to be qualified to participate in such activity. I hereby release, discharge, covenant 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 have been caused in whole or in part by the negligence of the Releasees or otherwise, 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 above Releasees, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS each of the Releasees from any litigation expenses, attorney fees, loss, liability, damage, or cost any Releasee may incur as the result of any such claim.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
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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