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I authorize as parent(s)/guardian(s) of the athlete, Maryland Allstar Athletics, LLC, its owners, members, agents, officers, employees, affiliates and assigns (collectively “Maryland Allstars”) to consent to medical treatment for my child when I cannot be reached.  I am fully aware of the risk of serious bodily injury that can occur in gymnastics/tumbling and cheerleading including but not limited to: blisters, muscle strains, ligament sprains, joint and muscle soreness, abrasions, contusions, stress fractures, concussions, broken bones, spinal cord injuries involving paralysis, permanent disability and even death.  I understand that Maryland Allstars takes the safety precautions necessary to reduce risk and cannot assume responsibility for any injuries or accidents that may occur.  I further agree to hold Maryland Allstars harmless for any bodily injury, disability, illness, death, or resulting expense, arising out of my child’s participation in any activities with Maryland Allstars whether or not caused by the negligence of Maryland Allstars.  I hereby release and forever discharge and hold harmless Maryland Allstars from and I assume full responsibility for all liabilities, losses, costs, actions, claims, and damages.  I give permission and grant to Maryland Allstars all right, title and interest for my child’s photograph to be used for the promotional and advertising purposes of Maryland Allstars.  I also agree not to use Maryland Allstars logo to create, sell or distribute any items pertaining to Maryland Allstars without expressed written consent.   This authorization and release form is valid until otherwise revoked in writing by parent or guardian. This Agreement shall be governed, enforced, performed and construed in accordance with the laws of the State of Maryland, without reference to principles of conflicts of law.  If any dispute or controversy arises among the parties concerning any provision contained herein or the relationship between the parties, I hereby agree to the exclusive jurisdiction of the courts located in Carroll County, Maryland (or if jurisdiction exists, in the United States District Court for the District of Maryland, Northern Division). I HEREBY AGREE TO AND DO WAIVE A TRIAL BY JURY IN ANY ACTION, PROCEEDING, OR COUNTERCLAIM BROUGHT BY EITHER OF THE PARTIES HERETO AGAINST THE OTHER ARISING OUT OF THIS AGREEMENT AND THE RELATIONSHIP BETWEEN THE PARTIES. I hereby agree to pay any and all attorneys’ fees, expert witness fees and all costs incurred by Maryland Allstars arising out of, or in any way related to, this Agreement and the relationship between the parties.

 

First Participant's Name

First Name*

Last Name*
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*
Parent or Guardian's Email Address

Email*

Confirm Email*
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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.
Parent or Guardian's Name

First Name*

Last Name*
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.


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