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MUD VOLLEYBALL PARTICIPATION WAIVER 

August 1, 2026

In consideration for the acceptance of my entry and participation in the Keep Northern Illinois Beautiful Mud Volleyball Tournament (Tournament”), I, the undersigned, intending to be legally bound for myself, my estate, my heirs, my executors, my administrators and my assigns, do hereby represent that I am physically able to participate in the Tournament. I fully understand and agree that my participation in the Tournament may entail the risk of physical injury. I agree to assume such risk and to waive any claim of any kind whatsoever, whether resulting from an injury or otherwise, resulting from my participation in the Tournament. I further agree to release, indemnify and hold harmless Keep Northern Illinois Beautiful and its directors, officers, employees, and agents, the City of South Beloit and its officers, employees, and agents, and any sponsors and/or representatives who participate in the staging and management of the Tournament from and against any and all losses, claims, suits, damages, liabilities and/or expenses, including attorney’s fees and costs, in connection with loss of life, personal or bodily injury and/or damage to or loss of property in any way related to my participation in the Tournament.

I agree to be personally responsible for any financial cost incurred as a result of my participation in the Tournament, including, and without limitation, transportation or medical expenses incurred as a result of any injury. 

I understand that Keep Northern Illinois Beautiful and the City of South Beloit assume no liability for lost, misplaced, stolen and/or damaged personal property and I hereby agree to release Keep Northern Illinois Beautiful, the City of South Beloit, and their respective directors, officers, employees, and agents from any such liability. 

I hereby irrevocably consent to and authorize Keep Northern Illinois Beautiful absolute right and permission to copyright and/or publish, or use photographic or video images of me, or in which I may be included in whole or in part, or composite or distorted in character or form, in conjunction with my own or a fictitious name, or reproductions thereof in color or otherwise, made through any media, for art, advertising, trade or any other lawful purpose whatsoever. I further waive any right that I may have to inspect and/or approve the finished product or the advertising copy that may be used in conjunction therewith, or the use to which it may be applied. I further release, discharge and agree to save Keep Northern Illinois Beautiful from any liability by virtue of any blurring, distortion, alteration, optical illusion, or use in composite form, whether intentional or otherwise, that may occur or be produced in the taking of said images, or in any processing tending towards the completion of the finished product. 

I acknowledge that I have carefully read this waiver and release and fully understand that it is a waiver and release of any and all claims against the entities listed above related to my participation in the Tournament. I hereby execute this waiver and release voluntarily. 

 June 16, 2026

First Participant's Name
First Name*
Middle Name
Last Name*
Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email*
Confirm Email*
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Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
Additional Information
Team Captain Name:
Team Name:
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 Age Acknowledgment*
Parent or Guardian's Date of Birth*
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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