Loading...

PARTICIPANT RELEASE AND LIABILITY WAIVER FORM
Every participant must have a completed and signed release form to turn in at the time of registration on the day of each event to participate.

Liability Release: For good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, I as parent or legal guardian of a minor (hereinafter "Minor"), hereby grant the permission necessary to allow Minor to participate in the above “Event” to be conducted by Sharp International Inc. I, in my own behalf and on behalf of Minor, further agree to release and to hold harmless Sharp International Inc., vendors and contractors, the hosting site, on whose premises the Event will occur (hereinafter the "Location"), and the respective directors, officers, representatives, members, staff and employees of the proceeding parties (hereinafter collectively "Releasees") from any and all liability whether caused by negligence of the Releasees or otherwise for any claim, judgment, loss, liability, cost and expenses (including, without limitations, attorney's fees and costs) arising out of or connected with the Event, including any claim arising out of or connected with any illness or injury (minimal, serious, catastrophic and / or death) that Minor may incur or sustain during the Event, all activities associated with the Event and while traveling to and from the site for the Event whether or not the Event actually occurs. I further expressly agree to indemnify and hold harmless Releasees and Releasees' heirs, successors, assigns, executors and administrators against loss from any claims, demands or actions that may subsequently be brought by Minor or by any other persons on the account of damages of any character resulting to Minor in any way from the foregoing activities. I further agree to reimburse and to make good to Releasees any loss or costs Releasees may have to pay as a result of any such action, claim or demand. I, in my own behalf and on behalf of Minor, hereby warrant that I have read this Liability Release in its entirety and fully understand its contents. I, in my own behalf and on behalf of Minor, am aware that this Liability Release releases from liability and contains an acknowledgement of my voluntary and knowing assumption of the risk of injury or illness. I, in my own behalf and on behalf of Minor, have signed this document voluntarily and of my own free will.

Supervision: A chaperone/Adult (age 21 and over) is required to attend with participants. This Chaperone will be responsible for the participants at all times. The Releasees are not responsible for participants’ supervision.
Appearance Agreement: I understand that as participant and/ or a spectator at the Event that Minor may be included in advertising contents such as, social media advertising or photographs taken during the Event. Therefore, without reservation or limitations, I, in my own behalf and on behalf of Minor, hereby assign, transfer and grant Sharp International Inc., its successors, assignees, licensees, sponsors, and the exclusive right to photograph and / or videotape Minor and to utilize such videotapes and photographs and Minor's name, face likeness, voice and appearance as a part of the Event or in any other media now in existence or hereafter developed, in advertising and promoting the Event, in advertising and promoting similar future events.
Medical Release: I, in my own behalf and on behalf of Minor, acknowledge and agree that such participation subjects Minor to possibility of physical illness or injury (minimal, serious, catastrophic and/ or death) and that I, in my own behalf and on behalf of Minor, acknowledge that Minor is assuming the risk of such illness or injury by participating in the Event. In the event of such illness or injury, I authorize Sharp International Inc. to obtain necessary medical treatment for Minor and hereby, in my own behalf and on behalf of Minor, release and hold harmless Releasees in the exercises of this authority. I further acknowledge and understand that I will be responsible for any and all medical and related bills that may be incurred on behalf of Minor for any illness or injury that Minor may sustain during the Event and while traveling to and from the site for the Event whether or not the Event actually occurs.
I represent that any medication to which Minor is allergic or medications that Minor is currently taking are listed below. I agree that Minor shall bring medications which Minor is currently taking with him / her to the Event and that he / she shall consume the prescribed dosage for such medications as needed.

 

December 6, 2022

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Information

School/Team Name: *

Event Date/Location: *

Division: *

Medications (if any):

Allergies (if any):
I acknowledge that the Minor suffers from the following conditions (Seizures, Epilepsy, Diabetes, Etc.:*
No
Yes

If yes please list
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

School/Team Name: *

Event Date/Location: *

Division: *

Medications (if any):

Allergies (if any):
I acknowledge that the Minor suffers from the following conditions (Seizures, Epilepsy, Diabetes, Etc.:*
No
Yes

If yes please list
Second Participant's Signature*
Third Participant's Name

First Name*

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

School/Team Name: *

Event Date/Location: *

Division: *

Medications (if any):

Allergies (if any):
I acknowledge that the Minor suffers from the following conditions (Seizures, Epilepsy, Diabetes, Etc.:*
No
Yes

If yes please list
Third Participant's Signature*
Fourth Participant's Name

First Name*

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

School/Team Name: *

Event Date/Location: *

Division: *

Medications (if any):

Allergies (if any):
I acknowledge that the Minor suffers from the following conditions (Seizures, Epilepsy, Diabetes, Etc.:*
No
Yes

If yes please list
Fourth Participant's Signature*
Fifth Participant's Name

First Name*

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

School/Team Name: *

Event Date/Location: *

Division: *

Medications (if any):

Allergies (if any):
I acknowledge that the Minor suffers from the following conditions (Seizures, Epilepsy, Diabetes, Etc.:*
No
Yes

If yes please list
Fifth Participant's Signature*
Sixth Participant's Name

First Name*

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

School/Team Name: *

Event Date/Location: *

Division: *

Medications (if any):

Allergies (if any):
I acknowledge that the Minor suffers from the following conditions (Seizures, Epilepsy, Diabetes, Etc.:*
No
Yes

If yes please list
Sixth Participant's Signature*
Seventh Participant's Name

First Name*

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

School/Team Name: *

Event Date/Location: *

Division: *

Medications (if any):

Allergies (if any):
I acknowledge that the Minor suffers from the following conditions (Seizures, Epilepsy, Diabetes, Etc.:*
No
Yes

If yes please list
Seventh Participant's Signature*
Eighth Participant's Name

First Name*

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

School/Team Name: *

Event Date/Location: *

Division: *

Medications (if any):

Allergies (if any):
I acknowledge that the Minor suffers from the following conditions (Seizures, Epilepsy, Diabetes, Etc.:*
No
Yes

If yes please list
Eighth Participant's Signature*
Ninth Participant's Name

First Name*

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

School/Team Name: *

Event Date/Location: *

Division: *

Medications (if any):

Allergies (if any):
I acknowledge that the Minor suffers from the following conditions (Seizures, Epilepsy, Diabetes, Etc.:*
No
Yes

If yes please list
Ninth Participant's Signature*
Tenth Participant's Name

First Name*

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

School/Team Name: *

Event Date/Location: *

Division: *

Medications (if any):

Allergies (if any):
I acknowledge that the Minor suffers from the following conditions (Seizures, Epilepsy, Diabetes, Etc.:*
No
Yes

If yes please list
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*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Insurance

Insurance Carrier*

Insurance Policy Number*

Relationship of Parent or Legal Guardian to Minor: *
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.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information

School/Team Name: *

Event Date/Location: *

Division: *

Medications (if any):

Allergies (if any):
I acknowledge that the Minor suffers from the following conditions (Seizures, Epilepsy, Diabetes, Etc.:*
No
Yes

If yes please list
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!