Name *

First Name

Last Name

Address

Address 1

Address 2

City

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Participation Waiver *

1. I Agree and acknowledge that I will be engaging in activities that involve risk of injury, including permanent disability and death, of which social and economic loss or damage might result not only from the participant’s own actions, inactions or negligence, but also the actions, inactions or negligence of other participants’ including but not limited to unforeseeable risks, the rules of play, the conditions of premises or equipment used. 2. Agrees that they I inspect the premises, all facilities and associated equipment and should the participant be of the opinion that such is unsafe, they must immediately advise the instructor/staff member/employee/representative of Ultimate Athlete of the conditions and refuse to participate until a suitable and satisfactory rectification occurs. 3. Assumes all foregoing risks arising from participating in and associated with the event and accepts all personal responsibility for any cost, expense, loss, damage, injury permanent or otherwise, disability or death. 4. Releases, waives and discharges Ultimate Athlete, its owners/proprietors/staff, its affiliated clubs, regional sports organizations, their respective administrators, directors, agents, instructors and other employees of the organization, other participants, sponsors, advertisers, and if applicable, owners and leasers of any used premises from any and all liability to the participant for any and all claims, costs, expenses, demands, losses or damages on account of injury including death or damage to property caused or alleged to be caused by negligence.

I have read and understand the above waiver.