WAIVER, RELEASE, AND STATEMENT OF PHYSICAL CONDITION

 

In consideration of the participation of my child, ________________________, in the Precision Track & Field Program, I, in my own right and as next friend of such minor child, for myself and for such minor child, our heirs, successors, administrators and assigns, hereby contractually waive, relinquish and release any and all rights, claims, actions and/or causes of action we may have against the Precision Track Club, Father Ryan High School, Montgomery Bell Academy, Franklin Road Academy, director Jan Sadler Pippin, and/or any volunteer coach or other club and school personnel including members of the Boards of Trust for personal injury or property damage arising from, or in any way connected with (including practice, travel, competition and any other activity connected with the program), the Precision Track & Field Program during the 2016 calendar year.

 

I further certify that the minor child named above is granted my permission to participate in the Precision Track & Field Program.  I am aware of the intensity of the training and competition involved and the associated risks, and I certify that such child is physically fit to participate in such program.  I further certify that I know of no physical condition or impairment which would, in any way, prevent such child from participating in the program.  In the event that such child needs emergency treatment of any kind, I grant my permission for Precision Track Club coaches and staff to offer and obtain such treatment.

 

I further acknowledge and accept the Precision Track Club policy requiring every club member to refrain from inappropriate behavior while traveling with the club, while competing with the club or while at club practice. Club members who exhibit inappropriate behavior while traveling with the club will be sent home at the Parentís/Guardianís expense.  ________(Parent/Guardian Initials)

 

I further understand that, with my childís membership, I assume the responsibility of helping with the competitions that the club shall put on in whatever capacity that I am qualified for.

 

Dated this ________ day of __________________, 2016

 

 

_____________________________                 __________________________________

Athleteís signature                                               Parentís/Guardianís signature

 

**Anyone participating in any capacity (parent, helper, coach, or athlete) with Precision Track Club must sign the liability waiver above.