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LIVEWIRE VOLLEYBALL LLC - PARTICIPATION WAIVER

RELEASE FOR PERSONAL INJURY AND DAMAGE

All physical activity has risks that may range from a fall, to muscle and ligament damage, to circulatory or heart disorders. Consequently you must make sure that your health is adequate to participate in the strenuous, vigorous physical activity involved in athletic participation. It is your responsibility to check with the physician of your choice about your health status and if there is any question regarding your fitness for participation. If you, at any time during your participation, experience any distress or have any questions regarding your participation, notify your coach. Livewire Volleyball LLC provides no participant accident insurance or athletic accident insurance for tryouts or participation in any organized team training, individual volleyball training, fitness training, LWSSA  (LW Speed, Strength and Agility, including weight training)  or open gym trainings.   You must provide your own medical coverage. 

RELEASE FOR COMMUNICABLE DISEASE EXPOSURE

Participant is fully aware and hereby acknowledges and accepts all risks of exposure to communicable diseases, including but not limited to, COVID-19, Coronaviruses, and MRSA.   Be aware that communicable diseases, including COVID-19, are excluded from all insurance coverages.

WHEREAS the undersigned voluntarily desires to participate in a team practice, play session, tryout, private lesson, open gym, camp, LWSSA or fitness training; USA Volleyball sanctioned or otherwise; and

WHEREAS the undersigned is duly aware of the risks and hazards that may arise through participation in said activities and that participation in said activities may result in loss of life, limb, property, or all three, of the undersigned.

THEREFORE, it is agreed as follows:

THAT in consideration of being allowed to participate in said activities, the undersigned hereby voluntarily assumes all risks and accident or damage to his/her person or property and all risks of liability or demands of any kind sustained, whether caused by the negligence of Livewire Volleyball LLC agents or employees, or otherwise; and

THE undersigned further voluntarily agrees that the above release shall be binding upon their heirs, administrators, executors, and assigns, of the undersigned; and

THE undersigned hereby affirms having accident and medical insurance coverage and having adequate health status to participate in strenuous physical activity. The undersigned further acknowledges that the undersigned has the right to refuse to attempt, or to withdraw from the physical activity for any reason. The undersigned accepts the responsibility to report any injury, illness, distress, or  preexisting condition that may impair performance, or other problems to the Livewire Volleyball coach and staff at Livewire.

THE undersigned, by signing this release, hereby certifies that the undersigned has read and fully understands and agrees with the conditions herein provided.

Today's Date: October 4, 2024 

First Athlete's Name

First Name*

Middle Name

Last Name*
First Athlete's Date of Birth*
First Athlete's Information

CLUB TEAM (most recent) *
First Athlete's Signature*
Second Athlete's Name

First Name*

Middle Name

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

CLUB TEAM (most recent) *
Third Athlete's Name

First Name*

Middle Name

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

CLUB TEAM (most recent) *
Fourth Athlete's Name

First Name*

Middle Name

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

CLUB TEAM (most recent) *
Fifth Athlete's Name

First Name*

Middle Name

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

CLUB TEAM (most recent) *
Sixth Athlete's Name

First Name*

Middle Name

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

CLUB TEAM (most recent) *
Seventh Athlete's Name

First Name*

Middle Name

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

CLUB TEAM (most recent) *
Eighth Athlete's Name

First Name*

Middle Name

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

CLUB TEAM (most recent) *
Ninth Athlete's Name

First Name*

Middle Name

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

CLUB TEAM (most recent) *
Tenth Athlete's Name

First Name*

Middle Name

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

CLUB TEAM (most recent) *
Parent or Guardian's Email Address

Email*

Confirm Email*
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Emergency Contact

First Name*

Last 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.


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*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

CLUB TEAM (most recent) *
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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