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RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, INDEMNITY, AND PARENTAL CONSENT AGREEMENT

FOR SUNDOG POND HOCKEY TOURNAMENT EVENT

In consideration of participating in the Pond Hockey Tournament to be held at Maine Sport Outfitters in Rockport, Maine and benefitting Midcoast Outdoor Leadership Initiative DBA Sundog Outdoor Leadership Initiative (the “Event”), I represent that I understand the nature of outdoor winter sports and pond hockey activities and that I and/or my minor child are competent, qualified, in good health, and in proper physical condition to participate in the Event. I acknowledge that if I and/or my minor child believe the Event conditions are unsafe, I and/or my minor child will immediately discontinue participation in the Event and any related activities.

I fully understand that the Event involves risks of serious bodily injury, including permanent disability, paralysis, and death. These risks include but are not necessarily limited to cuts, bruises, muscular strains, sprains and tears, closed or open head injuries or trauma, concussion, dislocation of joints, broken bones, collisions with players or equipment, falls on ice, loss of balance, hypothermia, frostbite, cold-related illness, and other physical or mental injuries, which may be caused by my own actions or inactions, those of others participating in the Event, the conditions in which the Event takes place, or the negligence of the “Releasees” named below. There may be other risks either not known to me or not readily foreseeable at this time, and I fully accept and assume all such risks and all responsibility for any losses, costs, and damages that I and/or my minor child incur as a result of participation in the Event and any related activities.

I hereby release, discharge, and covenant not to sue Midcoast Outdoor Leadership Initiative, their respective administrators, directors, agents, officers, volunteers, and employees, other participants, any sponsors, advertisers, and all owners and lessors of the premises on which the Event takes place (each considered one of the “Releasees” herein) from all liability, claims, demands, losses, or damages on my and/or my minor child’s account caused or alleged to be caused in whole or in part by the negligence of the Releasees or otherwise, including negligent rescue operations.

I further agree that if, despite this release, waiver of liability, and assumption of risk, I, or anyone on my and/or my minor child’s behalf, makes a claim against any of the Releasees, I will indemnify, save, and hold harmless each of the Releasees from any loss, liability, damage, or cost which any may incur as the result of such claim. I hereby consent to receive any medical treatment which may be deemed advisable for me and/or my minor child in the event of injury and/or illness during the Event. I understand that I or my health insurer (and not any of the Releasees or their insurers) will be responsible to pay for any and all expenses related to such injury and/or illness.

In addition, I hereby authorize any of the Releasees and/or their agents to photograph, film, tape, or otherwise create audio and/or video recordings, still images, and/or textual descriptions of me and/or my minor child, and to use the same for any legitimate purpose, including promotional and educational purposes, without compensation or further permission. I hereby consent to be recorded, photographed, and/or videotaped in connection with the Pond Hockey Tournament and grant Midcoast Outdoor Leadership Initiative permission to use my likeness in any publication, including web-based and social media publications, without payment or other consideration. I understand that all such media will become the property of Midcoast Outdoor Leadership Initiative and will not be returned. I hereby irrevocably authorize Midcoast Outdoor Leadership Initiative to edit, alter, copy, exhibit, publish, or distribute these materials for any lawful purpose. I waive any right to inspect or approve the finished product and any right to royalties or other compensation related to their use.

I certify that I am at least 18 years of age and have read this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, INDEMNITY, AND PARENTAL CONSENT AGREEMENT. I understand that I have given up substantial rights by signing it and have signed it freely and voluntarily. I intend this to be a complete and unconditional release of all liability to the greatest extent permitted by law. If any portion of this Agreement is held to be invalid, the remainder shall continue in full force and effect. This document shall be binding upon me and my minor child, including heirs, executors, administrators, assigns, and any legal guardian.



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*
Confirm Email*
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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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