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CTDA, LLC dba Midwest Cheer Elite - Atlanta

WAIVER OF LIABILITY, RELEASE, INDEMNITY, AND ASSUMPTION OF RISK AGREEMENT

 

CTDA, LLC dba Midwest Cheer Elite - Atlanta

WAIVER OF LIABILITY, RELEASE, INDEMNITY, AND ASSUMPTION OF RISK AGREEMENT

BY SIGNING THIS DOCUMENT YOU WILL WAIVE CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE. 

PLEASE READ CAREFULLY.

In consideration of the services of CTDA, LLC dba Midwest Cheer Elite Atlanta, its owners, agents, officers, subcontractors, employees, and all other persons or entities acting in any capacity on its or their behalf, including but not limited to Midwest Cheer Elite, Inc., 180 Pro and 180 Pro Tumble Academy, facilities, facility landlords and owners Givens Properties, Inc. (hereinafter collectively referred to as “CTDA”) and in consideration of me or my minor(s) being allowed to participate or the opportunity to participate in CTDA related facilities, events, activities, and equipment, I hereby agree on behalf of myself, my child, my spouse, my child’s other parent(s) or guardian(s), my parents, my family members, my agents, my and his/her/their heirs, assigns, personal representative, and estate (collectively, the “releasing parties” and/or “releasors”), as follows:

1.  I understand and acknowledge that the activities that I, my child, or any of the releasing parties engage in or observe while on CTDA’s premises, or while under the auspices, supervision, or control of CTDA, or while traveling to or from such activities, pose known and unknown risks which could result in injury, pain, suffering, paralysis, death, emotional distress, loss of companionship, and/or damage to me, to my child, to property, to the releasing parties, and/or to third parties.  The following describes some, but not all of those risks, and I understand and acknowledge that there are other risks, both foreseeable and not foreseeable, that are not included among the following which any of the releasing parties may suffer: Cheerleading, Dance, and Gymnastics, including performances of stunts and use of trampolines and other equipment, is dangerous and entails certain risks that simply cannot be eliminated without jeopardizing the essential qualities of the activity.  Without a certain degree of risk, cheerleading students would not improve their skills and the enjoyment of the sport would be diminished. Cheerleading, Dance, and Gymnastics expose participants to the usual risk of cuts and bruises, and other more serious risks as well. Participants often fall, can come in contact with other participants or equipment and other objects, can sprain or break wrists and ankles, can incur injuries caused by others, and can suffer more serious injuries.  Traveling to and from practice, rehearsals, shows, meets, competitions, and exhibitions raises the possibilities of any manner of transportation accidents.

2.  I confirm that I and my minor(s) listed on this waiver are physically capable and fit to participate in CTDA activities, and none of us have any medical condition or need other than those listed below.  Neither I nor my minor(s) are under the influence of alcohol or any mind-altering substance nor will carry, use, or consume these substances before or during activities at CTDA.

3.  I certify that my child has health, accident and liability insurance to cover bodily injury or property damage that may be caused or suffered while participating in this event or activity, or else I agree to bear the costs of such injury or damage to my child. I further certify that I am willing to assume and bear the costs of all risks that may arise or be created, directly or indirectly, through or by any such condition. 

4.  I represent and warrant to CTDA that adequate health, accident, and liability insurance is in force and will be maintained to cover any Costs, and if such Costs are not paid in full, then CTDA shall not have, and I hereby release CTDA from, any obligation to pay or reimburse any such Costs, and I agree to pay the Costs. 

5.  I hereby release CTDA to render first aid in the event of any injury or illness, to seek medical assistance if deemed necessary, and to transport to a medical facility or call an ambulance.   

6.  I understand that my athlete’s photograph/video may be taken during the course of class instruction or during an event.  I hereby grant my permission for the resulting photograph and/or video to be used for any and all publicity and printing purposes.

7.  My participation and that of my minor(s) is purely voluntary. No one has forced or coerced me or my child to participate. I elect for myself and my children to participate in such activities in spite of the physical, mental, emotional, and/or other possible risks both known and unknown.

8.  I expressly agree for myself and releasing parties, knowingly and freely accept and assume all of the risks, known and unknown, foreseeable and not foreseeable, related to, arising out of, or in any way connected with CTDA-related activities to the fullest extent of the law, even if arising from negligence from CTDA or other participants, including but not limited to performance of stunts and use of trampolines and other equipment, and the negligent acts or omissions of CTDA or others.

9.  On behalf of myself, my minor(s), and the releasing parties, I hereby voluntarily release, forever discharge, and agree to defend, hold harmless, and indemnify CTDA from any and all liability, claims, demands, costs, damages, actions, or rights of actions asserted by any of the releasing parties, which are related to, arise out of, or are in any way connected with my or my child’s participation in CTDA-related activities (“Costs”).  CTDA and its employees, officers, and instructors shall not be responsible for losses and damage associated with participation in any activity, exhibition, competition, clinic or travel to and from any event in which the above name is involved.  

10.  I, for myself and minor(s), agree to follow the terms, rules and conditions for participation in CTDA activities and will follow the instructions of the CTDA staff.  If I become aware of or observe any hazard or potentially dangerous condition during my attendance or participation, I will remove myself and my minor(s) from participation and notify the nearest CTDA staff immediately.  If I do not agree with the resolution as outlined by CTDA staff, I will remove myself and my minor(s) from participation immediately.  

11.  I, for myself and minor(s), agree that I have waived my right to maintain any lawsuit against CTDA on the basis of any claim from which I did not follow the terms, rules, and conditions for participating in CTDA activities.

12.  I acknowledge that if anyone is hurt or property is damaged during my participation or the participation of my minor(s) in a CTDA related activity, I may be found by court of law to have waived my right to maintain a lawsuit against CTDA on the basis of any claim from which I have released CTDA by signing this agreement.

13,  Should CTDA incur attorney’s fees or costs related to or arising from my obligations under this agreement, I agree to indemnify and reimburse CTDA for such attorney fees and costs. 

14.  I agree that the substantive and procedural laws of the State of Georgia shall apply to this agreement and in any action arising from this agreement without regard to the conflict of laws rules of the State of Georgia, that the state courts of Georgia shall have exclusive jurisdiction of any action, and that such action shall be brought only in the county in which CTDA is located. 

15.  I have been afforded the opportunity to ask for any explanations and to ask any questions concerning this document, and I have not been given any other information, oral or written, that in any way changes the above information. 

16.  I acknowledge and agree that this agreement is intended to be as broad and inclusive as is permitted by the laws of the State of Georgia, and that if any provision of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect.

17.  The Releasing Parties, (a) HEREBY RELEASE CTDA ("Releasees") WITH RESPECT TO ANY AND ALL LIABILITY, CLAIM, OR LAWSUIT, INCLUDING BUT NOT LIMITED TO INJURY, PARALYSIS, DISABILITY, AND DEATH, and loss or damage to person or property arising out of or related to my presence or participation, and that of my minor(s), at CTDA related activities WHETHER ARISING FROM NEGLIGENCE OF THE RELEASEES OR OTHERWISE (but not including gross negligence or willful misconduct) to the fullest extent permitted by law (collectively, "Released Claims" and/or “Costs”), and (b) covenant not to sue any Releasees regarding any Released Claim and/or Cost.

18.  The Releasors hereby indemnify and hold harmless the Releasees from any and all damages arising out of or related to any Released Claim, any false, inaccurate, or misleading statement in this agreement, or any failure of the releases and waivers in this agreement to be enforceable.  Such damages may include but are not limited to medical costs and attorney’s fees.

I HAVE HAD SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT.  I HAVE CAREFULLY READ THIS ACKNOWLEDGMENT AND ASSUMPTION OF RISK, RELEASE OF LIABILITY AND PARTICIPANT AGREEMENT, FULLY UNDERSTAND ITS CONTENTS, AND SIGN IT VOLUNTARILY WITH THE INTENT OF BINDING MYSELF.  IT IS MY INTENTION TO GRANT PERMISSION FOR MY MINOR(S) TO PARTICIPATE IN ANY AND ALL ASPECTS OF CTDA’S FACILITIES AND ACTIVITIES AND TO ASSUME AND ACCEPT ALL RISKS ASSOCIATED THEREWITH. IT IS MY INTENTION TO EXEMPT AND RELIEVE RELEASEES FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH CAUSED BY ANY CAUSE, INCLUDING NEGLIGENCE.  I HEREBY GIVE MY CONSENT FOR THE PARTICIPANT WHOM I AM RESPONSIBLE AND WHOSE NAME IS LISTED BELOW. 

I Agree

November 22, 2019

 

First Participant's Name

First Name*

Last Name*
First Participant's Date of Birth*
First Participant's Information
Does the participant have any conditions and/or limitations that CTDA, LLC needs to be aware of?*
No
Yes

If yes, please list them.
Does the participant take any medication that CTDA, LLC needs to be aware of?*
No
Yes

If yes, please list them.
Does the participant have a cell phone number that can receive text messages?*
No
Yes

If yes, please enter the number including area code.
Does participant have a personal email address that can receive gym-wide information?*
No
Yes

If yes, please enter the email address.
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information
Does the participant have any conditions and/or limitations that CTDA, LLC needs to be aware of?*
No
Yes

If yes, please list them.
Does the participant take any medication that CTDA, LLC needs to be aware of?*
No
Yes

If yes, please list them.
Does the participant have a cell phone number that can receive text messages?*
No
Yes

If yes, please enter the number including area code.
Does participant have a personal email address that can receive gym-wide information?*
No
Yes

If yes, please enter the email address.
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information
Does the participant have any conditions and/or limitations that CTDA, LLC needs to be aware of?*
No
Yes

If yes, please list them.
Does the participant take any medication that CTDA, LLC needs to be aware of?*
No
Yes

If yes, please list them.
Does the participant have a cell phone number that can receive text messages?*
No
Yes

If yes, please enter the number including area code.
Does participant have a personal email address that can receive gym-wide information?*
No
Yes

If yes, please enter the email address.
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information
Does the participant have any conditions and/or limitations that CTDA, LLC needs to be aware of?*
No
Yes

If yes, please list them.
Does the participant take any medication that CTDA, LLC needs to be aware of?*
No
Yes

If yes, please list them.
Does the participant have a cell phone number that can receive text messages?*
No
Yes

If yes, please enter the number including area code.
Does participant have a personal email address that can receive gym-wide information?*
No
Yes

If yes, please enter the email address.
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information
Does the participant have any conditions and/or limitations that CTDA, LLC needs to be aware of?*
No
Yes

If yes, please list them.
Does the participant take any medication that CTDA, LLC needs to be aware of?*
No
Yes

If yes, please list them.
Does the participant have a cell phone number that can receive text messages?*
No
Yes

If yes, please enter the number including area code.
Does participant have a personal email address that can receive gym-wide information?*
No
Yes

If yes, please enter the email address.
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information
Does the participant have any conditions and/or limitations that CTDA, LLC needs to be aware of?*
No
Yes

If yes, please list them.
Does the participant take any medication that CTDA, LLC needs to be aware of?*
No
Yes

If yes, please list them.
Does the participant have a cell phone number that can receive text messages?*
No
Yes

If yes, please enter the number including area code.
Does participant have a personal email address that can receive gym-wide information?*
No
Yes

If yes, please enter the email address.
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information
Does the participant have any conditions and/or limitations that CTDA, LLC needs to be aware of?*
No
Yes

If yes, please list them.
Does the participant take any medication that CTDA, LLC needs to be aware of?*
No
Yes

If yes, please list them.
Does the participant have a cell phone number that can receive text messages?*
No
Yes

If yes, please enter the number including area code.
Does participant have a personal email address that can receive gym-wide information?*
No
Yes

If yes, please enter the email address.
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information
Does the participant have any conditions and/or limitations that CTDA, LLC needs to be aware of?*
No
Yes

If yes, please list them.
Does the participant take any medication that CTDA, LLC needs to be aware of?*
No
Yes

If yes, please list them.
Does the participant have a cell phone number that can receive text messages?*
No
Yes

If yes, please enter the number including area code.
Does participant have a personal email address that can receive gym-wide information?*
No
Yes

If yes, please enter the email address.
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information
Does the participant have any conditions and/or limitations that CTDA, LLC needs to be aware of?*
No
Yes

If yes, please list them.
Does the participant take any medication that CTDA, LLC needs to be aware of?*
No
Yes

If yes, please list them.
Does the participant have a cell phone number that can receive text messages?*
No
Yes

If yes, please enter the number including area code.
Does participant have a personal email address that can receive gym-wide information?*
No
Yes

If yes, please enter the email address.
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information
Does the participant have any conditions and/or limitations that CTDA, LLC needs to be aware of?*
No
Yes

If yes, please list them.
Does the participant take any medication that CTDA, LLC needs to be aware of?*
No
Yes

If yes, please list them.
Does the participant have a cell phone number that can receive text messages?*
No
Yes

If yes, please enter the number including area code.
Does participant have a personal email address that can receive gym-wide information?*
No
Yes

If yes, please enter the email address.
Parent or Guardian's Email Address

Email*

Confirm Email*
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
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*

Relationship*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
Does the participant have any conditions and/or limitations that CTDA, LLC needs to be aware of?*
No
Yes

If yes, please list them.
Does the participant take any medication that CTDA, LLC needs to be aware of?*
No
Yes

If yes, please list them.
Does the participant have a cell phone number that can receive text messages?*
No
Yes

If yes, please enter the number including area code.
Does participant have a personal email address that can receive gym-wide information?*
No
Yes

If yes, please enter the email address.
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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