Release and Waiver
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RELEASE AND WAIVER STEEL CITY SELECT BASEBALL LLC. 724-935-7445
Every Player must have a completed and signed release form on file to participate. ALL areas must be completed.
Player Name: ______Address: ______City, State & Zip: ______Parent Phone Number: ______Parent Email Address: ______Player Date of Birth: ______Name of Parent/Legal Guardian: ______Name of Team: ______
Liability Release. I, as Player (and Parent or Guardian, as applicable) assume full responsibility for the risk of injury, death or property damage or cost that may incur due to my participation hereunder, on the above Team/Lessons/or Programs and/or in or on the Locations herein used by Steel City Select Baseball, LLC for lessons/programs/or team activity. I further agree to release and to hold harmless Steel City Select, LLC, Matt Diesel, the playing site(s) on whose premises the Team will play, or where lessons/programs take place (the "Locations"), and their respective directors, officers, representatives, members, agents, contractors and employees (collectively "Releasees") from any and all actual and potential, known and unknown, suspected and unsuspected liabilities and damages, whether caused by negligence of the Releasees or otherwise for any claims, cause of action, judgment, loss, liability, cost and expenses (including, without limitations, attorney's fees and costs) arising out of or connected with my participation hereunder and/or with the Team/Lessons/or Programs, including any claim arising out of or connected with any illness or injury that I may incur or sustain during participation hereunder and/or with the Team/Lessons/or Programs, and for all activities associated hereunder and/or with the Team/Lessons/or Programs. I further expressly agree to indemnify and hold harmless Releasees and Releasees' heirs, successors, assigns, executors and administrators against loss from any further claims, demands or actions that may subsequently be brought by any other persons on the account of damages of any character resulting to me in any way from the foregoing activities. I further agree to reimburse and to make good to Releasees any loss, or costs Releasees may have to pay as a result of any such action, claim, or demand.
Medical Release. I acknowledge and agree that such participation subjects me to the possibility of physical illness or injury (minimal, serious, catastrophic and/ or death) and that I acknowledge that I am assuming the risk of such illness or injury by participating with the Team/Programs/or Lessons. In the event of such illness or injury, I authorize Releasees to obtain necessary medical treatment for me and hereby release and hold harmless Releasees in the exercises of this authority. I further acknowledge and understand that I will be responsible for any and all medical and related bills that may be incurred on my behalf for any illness or injury that may be sustained by participating hereunder and/or with the Team/Programs/or Lessons.
Insurance Information Insurance Company: ______Medical Insurance Policy/Group Number - ______
Appearance Agreement. I understand that Steel City Select, LLC, from time to time produces promotional material relating to its programs. I understand that as a participant hereunder and/or with the Team/Program/or Lessons and/ or a spectator at the Location, that I may be included in videotapes, photographs, DVDs, podcasts, and videocasts. Therefore, without reservation or limitations, I hereby assign, transfer and grant to Steel City Select, LLC, its agents, representatives, employees, successors, assignees, licensees, sponsors, any television networks, and all other commercial exhibitors the exclusive right to photograph and / or videotape me and to utilize such videotapes and photographs and my name, face likeness, voice and appearance hereunder and/or as a part of the Team/Program/or Lessons, in advertising and promoting Steel City Select, LLC, and/or the Team/Program/or Lessons, or in advertising and promoting similar future events. I further understand that neither Steel City Select, LLC, nor any third party is under any obligation to exercise any of the foregoing rights, licenses and privileges. I waive any right to inspect or approve the copies of any promotional materials related thereto.
Team/Program/Lesson Rules. I further acknowledge and understand that Steel City Select, LLC has established rules and regulations pertaining to conduct, behavior and activities of all players, by which I agree to abide hereunder and/or while on the Team/or participating in any Lessons/Programs, and that I will be responsible for my failure to abide by those rules and regulations. I understand that violation of the rules can result in dismissal from the Team/Program/Lessons with no refund.
I hereby warrant that I have read this Release and Waiver Form in its entirety and fully understand and agree with its contents. I am aware that this Release and Waiver Form releases Releasees from liability and contains an acknowledgement of my voluntary and knowing assumption of the risk of injury or illness. I have signed this document voluntarily and of my own free will. I agree that all obligations assumed and promises made by me shall be binding on my heirs, executors and administrators of our estate.
Signature of Player:______Date: ______Witness Signature: ______Witness Name: ______
Emergency Contact Name to contact: ______Telephone: ______
For Parents or Guardians of Player of Minor Age (Under Age 18 at Time of Registration)
This is to certify that I, as parent or guardian with legal responsibility for this Player, do consent and agree to this Release and Waiver as provided above, and for myself, my heirs and next of kin. I hereby grant the permission necessary to allow Player to participate on the above Team, I, in my own behalf and on behalf of the Player, hereby warrant that I have read this Release and Waiver Form in its entirety and fully understand its contents. I, in my own behalf and on behalf of the Player, am aware that this Release and Waiver Form releases Releasees from liability and contains an acknowledgement of my voluntary and knowing assumption of the risk of injury or illness. I, in my own behalf and on behalf of the Player, have signed this document voluntarily and of my own free will. I, in my own behalf and on behalf of the Player, agree that all obligations assumed and promises made by the Player shall be binding on me as Parent or Legal Guardian, and our respective heirs, executors and administrators.
Signature of Parent or Legal Guardian:______Date: ______Relationship to Player: ______Parent/Guardian Phone Number: ______
, Lesson Packages / Programs / Fall & Spring Teams
There are no refunds for lesson packages, programs or team payments.
***Please make sure there is a valid email address for lesson reminders, team communications, and email blasts about upcoming events and programs.
ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ALL ACTIVITIES AT Foglio Enterprises LLC d/b/a Sports and Courts, located at 304 Warrendale Road, Wexford, Pennsylvania 15090 (the “Complex”), including but not limited to, any risks that may arise from the negligence or carelessness of Foglio Enterprises LLC, its subsidiaries, affiliates, directors, officers, employees, partners, contractors, agents, representatives, volunteers, successors and assigns (collectively “Foglio Enterprises LLC”) and/or from Steel City Select Baseball, its subsidiaries, affiliates, directors, officers, employees, partners, contractors, agents, representatives, volunteers, successors and assigns (collectively “Steel City Select Baseball LLC”) and/or from dangerous or defective equipment or property owned, maintained, operated or controlled by Foglio Enterprises LLC and/or Steel City Select Baseball LLC.
I certify that I have not been advised to not participate in activities at the Complex by a qualified medical professional and that there are no health-related reasons or problems, which preclude my participation in activities at the Complex.
I am duly aware of the risks and hazards inherent upon engaging in or participating in activities at the Complex and I hereby elect to voluntarily enter the Complex, and to engage in or participate in activities at the Complex knowing that said activities or participation may be hazardous. The undersigned voluntarily assumes all risk of loss, damage or injury that may be sustained as a result of such participation and activities at the Complex.
In consideration for permitting me to engage in or participate in activities at the Complex, I agree for myself, my executors, administrators, heirs, successors, and assigns as follows:
(A) I WAIVE, RELEASE, AND DISCHARGE Foglio Enterprises LLC from any and all liability, including but not limited to, liability arising from the negligence of Foglio Enterprises LLC, for my death, disability, personal injury, property damage, property theft, or any other damage or actions of any kind which may affect or impact me in any way arising from activities at the Complex;
(B) I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE Foglio Enterprises LLC from any and all liabilities or claims made as a result of my participation in activities at the Complex, whether caused by the negligence of Foglio Enterprises LLC or otherwise.
This Accident Waiver and Release of Liability Form (“Release Form”) shall be construed in accordance with the laws of PA.
This Release Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under
I CERTIFY THAT I HAVE READ THIS DOCUMENT; AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL.
Date
Signature (if under 18 years old Parent/Guardian Age sign) PARENT/GUARDIAN WAIVER FOR MINORS (Under 18 years old) Parent/Guardian Name:
Participant Name:
Emergency Contact No.: