Summer Camp Emergency Medical Form & Participant(s) Release of Liability
Please read and be certain you understand the implications of signing. Express Assumption of Risk Associated with Sport, Venue Use and Related Activities.
I, _ ___ do hereby affirm and acknowledge that I have been fully informed of the inherent hazards and risks associated with participation in the Mark Cresse School of Baseball, transportation of equipment related to the activities, and travelling to and from activity sites in which I am about to engage. Inherent hazards and risks include but are not limited to:
1. Risk of injury from the activity and equipment utilized is significant including the potential for broken bones, severe injuries to the head, neck, and back or other bodily injuries that my result in permanent disability and death.
2. Possible equipment failure and/or malfunction or misuse of my own or others’ equipment.
3. I AGREE THAT I WILL WEAR APPROVED PROTECTIVE GEAR AS DECREED BY THE GOVERNING BODY OF THE MARK CRESSE SCHOOL OF BASEBALL. However, protective gear cannot guarantee the participant’s safety. I further agree that no helmet can protect the wearer against all potential head injuries or prevent injury to the wearer’s face, neck or spinal cord.
4. Variation and/or steepness of terrain, variation or changes in surfaces including but not limited to snow surfaces, ice, bare spots, rocks, stumps, debris, cliffs, trees, fences, posts, trees, light poles, signs, buildings, roads, walkways, ramps, rails, stairs, pyramids, manual pads, bowls, halfpipes, jumps, padded and non-padded barriers, other persons, and other natural and manmade hazards.
5. My own negligence and/or the negligence of others, including but not limited to operator error and guide decision making including misjudging terrain, weather, riding surfaces or other obstacles.
6. Exposure to the elements and temperature extremes may result if frost nip, frost bite, heat exhaustion, heat stroke, sunburn, hypothermia and dehydration.
7. Dangers associated with exposure to natural elements include but are not limited to avalanche, rock fall, inclement weather, thunder and lighting, severe and or varied wind, temperature and other weather conditions.
8. Accidents or illness occurring in remote places where there are no available medical facilities.
9. Fatigue, exhaustion, chill, and/or dizziness, which may diminish my/our reaction time and increase the risk of accident.
10. Impact or collision with other athletes, spectators, facility employees, pedestrians, motor vehicles, and cyclists.
*I understand the description of these risks is not complete and unknown or unanticipated risks may result in injury, illness , or death. Release of Liability, Waiver of Claims and Indemnity Agreement In consideration for being permitted to participate in the above described activities and related activities, I hereby agree, acknowledge and appreciate that:
1. I HEREBY RELEASE AND HOLD HARMLESS WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER CAUSED BY NEGLIGENCE OR OTHERWISE, the following named persons or entities, herein referred to as releases. MARK CRESSE SCHOOL OF BASEBALL AND ITS OFFICERS, EMPLOYEES, AND VOLUNTEERS.
2. To release the releases, their officers, directors, employees, representatives, agents, and volunteers from liability and responsibility whatsoever and for any claims or causes of action that I, my estate, heirs, survivors, executors, or assigns may have for personal injury, property damage, or wrongful death arising from the above activities whether caused by active or passive negligence of the releases or otherwise. By executing this document, I agree to hold the releases harmless and indemnify them in conjunction with any injury, disability, death, or loss or damage to person or property that may occur as a result of my engaging in the above activities.
3. By entering into this Agreement, I am not relying on any oral or written representation or statements made by the releases, other than what is set forth in this Agreement.
4. This agreement shall apply to any and all injury, disability, death, or loss or damage to person or property occurring at any time after the execution of this agreement. This release shall be binding to the fullest extent permitted by law. If any provision of this release is found to be unenforceable, the remaining terms shall be enforceable.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, I FULLY UNDERSTAND ITS TERMS, I UNDERSTAND THAT I HAVE GIVEN UP LEGAL RIGHTS BY SIGNING IT, AND I SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. FOR PARTICIPANTS OF MINORITY AGE: This is to certify that I, as Parent, Guardian, Temporary Guardian with legal responsibility for this participant, do consent and agree not only to his/her release of all Releases, but also to release and indemnify the Releases from any and all liabilities incident to his/her involvement in these programs for myself, my heirs, assigns, and next of kin.
e-Signature of Parent or adult legal Guardian if Participant is a Minor, Name of Parent or adult legal Guardian.
CAMPER: __ _ | __ __Date of Birth: _ __ | __ __Home Phone Number: ____ _____PARENT 1: ___ ___Cell Phone Number: ____ _____PARENT 2: ____ _________Daytime Number: ______ ______
FAMILY DOCTOR: ___ ______Phone Number: __ ____
In case of emergency and neither parent can be reached, we ask that you list the names and phone numbers of three friends or relatives as alternate emergency contacts.
Under most conditions a physician is not permitted to treat a minor without consent of a parent or legal guardian. This legal restriction is intended to protect the rights of parents or guardians, but because of it, if an emergency occurs, someone would try to contact you first. If this is unsuccessful, we need your consent to obtain emergency medical attention. Your signature below also certifies that your child has no medical problems that would prevent him/her from participating in our program. TO: Mark Cresse School of Baseball If during the course of my child’s activities in camp, he/she should become ill or sustain an injury, I hereby authorize you to obtain emergency medical care for (camper name(s)) _ __ __ | __ __
Leave this empty:
Your legal name
Your email address
Signed by Mark Cresse
Signed On: January 10, 2019
If you have questions about the contents of this document, you can email the document owner.
Document Name: Summer Camp Emergency Medical Form & Participant(s) Release of Liability
Agree & Sign