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WAIVER/RELEASE FOR COMMUNICABLE DISEASES INCLUDING COVID-19

ASSUMPTION OF RISK / WAIVER OF LIABILITY / INDEMNIFICATION AGREEMENT
In consideration of being allowed to participate on behalf of Worcester Cowboys Football & Cheer, Inc athletic
program and related events and activities, the undersigned acknowledges, appreciates, and agrees that:


1. Participation includes possible exposure to and illness from infectious diseases including but not limited to
MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of
serious illness and death does exist; and,


2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING
FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation;
and,


3. I willingly agree to comply with the stated and customary terms and conditions for participation as regards
protection against infectious diseases. If, however, I observe and any unusual or significant hazard during my
presence or participation, I will remove myself from participation and bring such to the attention of the nearest
official immediately; and,


4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE
AND HOLD HARMLESS (insert name of sports organization) their officers, officials, agents, and/or employees,
other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of
premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL ILLNESS,
DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE
NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

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 IF FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

 

FOR PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT THE TIME OF REGISTRATION)
This is to certify that I, as parent/guardian, with legal responsibility for this participant, have read and explained the
provisions in this waiver/release to my child/ward including the risks of presence and participation and his/her
personal responsibilities for adhering to the rules and regulations for protection against communicable diseases.
Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and
child/ward do consent and agree to his/her release provided above for all the Releasees and myself, my spouse,
and child/ward do release and agree to indemnify and hold harmless the Releasees for any and all liabilities incident
to my minor child’s/ward’s presence or participation in these activities as provided above, EVEN IF ARISING FROM
THEIR NEGLIGENCE, to the fullest extent provided by law.

* I also acknowledge that both myself and participant have read Worcester Cowboys Football & Cheer, Inc's COVID-19 Plan. 

 

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

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
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*
Check to receive information, news, and discounts by e-mail.
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*

Middle Name

Last Name*

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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