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PARTICIPANT WAIVER AND RELEASE OF LIABILITY

HAMMOND DEPARTMENT OF PARKS & RECREATION AND 219 PICKLEBALL LLC

Read Carefully – This Document Has Legal Implications

I understand that I am (or if signing on behalf of a minor under the age of 18 that the child is) voluntarily participating in Pickleball (the “Activity”) at the Jean Shepherd Community Center, which is a Hammond Department of Parks and Recreation (“Parks”) facility or at an affiliated Parks facility (Facility). I further understand that 219 Pickleball LLC is an entity that uses, manages, or is otherwise affiliated with Parks at the Facility.

I agree that the following persons or entities are the Released Parties herein: City of Hammond, Indiana, Mayor Thomas M. McDermott, Jr., Hammond Department of Parks and Recreation, Board of Parks Commissioners, 219 Pickleball, LLC, as well as their officers, employees, volunteers, representatives, agents, staff, referees, event organizers, sponsors, members, managers, and event volunteers.

Acknowledgement and Assumption of Risk: By voluntarily participating in this Activity, I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN THE ACTIVITY AND ANY/ALL RISKS ASSOCIATED WITH THE FACILITY AND/OR THE ACTIVITY, including but not limited to the inherent risks in the sport or Activity, any risks that may arise from negligence or carelessness on the part of the Released Parties, and from dangerous or defective equipment or property owned, maintained, or controlled by them.

I certify that I am physically fit, have sufficiently prepared or trained for participation in this Activity, and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in this Activity.

I acknowledge that this Activity may involve a test of a person's physical and mental limits and carries with it the potential for death, serious injury, and property loss. The risks include, but are not limited to, those caused by facilities, temperature, condition of other participants, equipment, lack of hydration, and actions of other people including, but not limited to, participants, volunteers, monitors, producers/organizers of the activity, or Released Parties. Said risks further include any and all communicable diseases including but not limited to COVID-19, MRSA and other viruses and diseases spread through human contact and by humans interacting with each other in close proximity to one another.

Waiver, Release, Indemnification and Hold Harmless. In consideration of my voluntary participation and by permitting me to participate in this activity, I hereby, for myself, my executors, administrators, heirs, next of kin, successors, and assigns affirmatively state and agree as follows:

(A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the Released Parties, for my death, disability, personal injury, property damage, property theft, or damages of any kind which may hereafter occur to me.

(B) I FURTHER AGREE TO INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the Released Parties from any and all liabilities or claims made as a result of my participation in this activity, whether caused by the negligence of the Released Parties or otherwise.

I acknowledge that the Released Parties are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific activity at the Facility.

I hereby give my consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity. In the event that I should require medical care or treatment I authorize Parks and/or 219 Pickleball, LLC to provide all emergency medical care deemed necessary, including but not limited to first aid, CPR, use of AEDs, emergency medical transport, and sharing of medical information with medical first responder personnel. I further agree to be responsible for all costs associated with said medical care and am aware that I should carry my own health insurance.

I understand while participating in this activity, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the activity holders, producers, sponsors, organizers, and assigns. 


This Waiver and Release of Liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law and that Indiana law shall govern this document without regard to any conflict of law principles.

In the event that any damage to equipment or facilities occurs as a result of my or the minor that I am signing on behalf on below (if applicable) willful actions, negligence, or recklessness, that I acknowledge and agree to be held responsible for payment and liable for any and all costs associated with any such actions.

In the event that any provision of this document is held invalid by a court of competent jurisdiction, the remainder of this document shall remain in full force and effect.

I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL ON MY BEHALF AND/OR ON BEHALF OF THE BELOW MINOR CHILD OF WHICH I HAVE THE AUTHORITY TO SIGN AND ACKNOWLEDGE THAT I UNDERSTAND THAT SAID MINOR CHILD SHALL ALSO BE BOUND BY THE TERMS HEREIN.

June 16, 2026

First Participant's Name
First Name*
Middle Name
Last Name*
Phone*
First Participant's Date of Birth*
Date of Birth
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
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Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
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*
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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