Feb 4, 2017 - USPA Utah State Championships Waiver Form
RELEASE OF LIABILITY -- READ BEFORE SIGNING
In consideration of being allowed to participate in any way in the 2017 USPA Utah State Championships, USPA , its related events and activities,I, , the undersigned, acknowledge, appreciate, and agreethat:1. The risk of injury from the activities involved in this program is significant, including thepotential for permanent paralysis and death, and while particular skills, equipment, and personaldiscipline may reduce this risk, the risk of serious injury does exist; and,2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IFARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility formy participation; and,3. I willingly agree to comply with the stated and customary terms and conditions for participation.If, however, I observe any unusual significant hazard during my presence or participation, I willremove myself from participation and bring such to the attention of the USPA officialsimmediately; and,4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin,HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS THE Meet Director/promoter, USPA, Ironground Gym, Chris McGrail, Utah Powerlifting LLC, and their officers,officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers,and, if applicable, owners and lessors of premises used for the activity ("Releasees"), WITHRESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property,WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullestextent permitted by law.
FOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE(UNDER AGE 18 AT TIME OF REGISTRATION)
This is to certify that I, as parent/guardian with legal responsibility for this participant, do consentand agree to his/her release as provided above of all the Releasees, and, for myself, my heirs,assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from anyand all liabilities incident to my minor child's involvement or participation in these programs asprovided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extentpermitted by law. Emergency Phone #: Date Signed:
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT , FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
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Document Name: Feb 4, 2017 - USPA Utah State Championships Waiver Form
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