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CLAGGETT POWER SKATING ACADEMY

Waiver Form

This form must be filled out by players 18 or older, or by parents/gaurdians of a player under the age of 18, before they participate in any 'Claggett Power Skating Academy' lessons, camps, or practices.

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On behalf of myself, my heirs, assigns, executors, administrators, and any others who may take by or through me do hereby grant to Clagget Power Skating Academy, its employees and agents, and its assigns, permission to take and use my name, picture, image, likeness, actions, voice, biographical information, hometown information, or other personally identifiable information in whole or in part, individually or in conjunction with other images or audio recordings. Personally identifiable information may be captured in audio/visual form as part of any type of recording, including but not limited to photographs, digital images, drawings, renderings, voices, sounds, video recordings, audio clips, or accompanying written descriptions. I understand and agree that the personally identifiable information may be used in any and all forms of media and in all manners, within an unrestricted geographic area, including but not limited to, composite or edited forms without notifying me in advance of such use. I waive any right to inspect or approve the finished version of any use including images or any printed or electronic matter that may be used with them.


I waive all rights of privacy or compensation, which I may have in connection with such use of my name, picture, image, likeness, actions, voice, biographical or other personally identifiable information. Without limiting the foregoing, I understand that Clagget Power Skating Academy may post or otherwise release my name, biographical information, images, recordings, or other personally identifiable information on the internet or by other means, and that other political committees, news outlets, or third parties may then use such information.


I release Claggett Power Skating Academy, its employees, directors, officers, agents, contractors, volunteers, and/or others associated with the company from any claims, damages or liability that I may have in connection with the taking or use of the images, audio recordings, personally identifiable information, or the printed or audio or electronic material used with the images or audio recordings.


I am at least 18 years of age (or the age of majority in my state) and competent to sign this release for myself or for the person I am parent or guardian of who is under 18, and I have read the release before signing. I understand its contents, meaning and impact and I freely accept the terms. 

Acknowledgement of Purchase

Through the purchase of Activity Sessions, I have agreed to voluntarily participate in physical activity, including, but not limited to hockey skill, skating & hockey fitness development under the guidance of Claggett Power Skating Academy.

 

Waiver and Release of Liability and Assumption of Risk

 

In consideration of the risk of injury that exists while participating in Claggett Power Skating Academy (hereinafter the “Activity”); and in consideration of my desire to participate in said Activity and being given the right to participating in same; I HEREBY, for myself, my heirs, executors, administrators, assigns, or personal representatives (hereinafter collectively, “Releasor,” “I” or “me”, which terms shall also include Releasor’s parents or guardian if Releasor is under 18 years of age), knowingly and voluntarily enter into this WAIVER AND RELEASE OF LIABILITY and hereby waive any and all rights, claims and causes of action of any kind arising out of my participation in the Activity; and

I HEREBY release and forever discharge Claggett Power Skating Academy, their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors, and assigns (collectively “Releasees”), from any physical or psychological injury that I may suffer as a direct result of my participation in the aforementioned Activity.

I am voluntarily participating in the aforementioned Activity and I am participating in the Activity entirely at my own risk. I am aware of the risks associated with participating in this Activity, which may include, but are not limited to: physical or psychological injury, pain, suffering, illness, disfigurement, temporary or permanent disability (including paralysis), economic or emotional loss, and death. I understand that these injuries or outcomes may arise from my own or others’ negligence, conditions related to travel to and from the Activity, or from conditions at the activity location(s). Nonetheless, I assume all related risks, both known and unknown to me, of my participation in this Activity.

 

I FURTHER AGREE to indemnify, defend and hold harmless the Releasees against any and all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf, including attorney’s fees and any related costs.

Acknowledgement of Health

I declare and acknowledge that I am physically and mentally sound and suffering from no condition, impairment, disease, infirmity, or other illness that would prevent participation in said activity or use of equipment (as defined below). I acknowledge I have been informed of the need for a physician’s approval for the participation in activity or in the use of equipment to learn hockey based training techniques, skills, and fitness. I recognize it is my sole responsibility to obtain an examination by a physician prior to involvement in any activity program. I acknowledge that I have had a physical examination and have been given a physician’s permission to participate, or I have chosen not to obtain a physician’s permission prior to beginning this exercise program with Claggett Power Skating Academy, and I acknowledge I am doing so at my own risk.

Equipment & Assumption of Risk

Claggett Power Skating Academy, I, a chosen fitness facility, or a rink of choice, will provide the equipment to be used in connection with hockey workouts, including, but not limited to: hockey nets, hockey sticks, hockey pucks, synthetic ice, balance boards, stick handling balls, weights, a workout space or area, ice rink, and any other equipment that can be provided. I understand and recognize that I have full control over the area in which we perform our workouts. I represent and warrant any and all equipment I provide or choose to use for activity is for personal use only.

I acknowledge that Claggett Power Skating Academy has not inspected my equipment, the chosen fitness facilities’, or the rink of choice’s equipment and has no knowledge of its condition. I understand and I take sole responsibility for my equipment provided and activity area of choice. I also acknowledge that although Claggett Power Skating Academy takes precautions to maintain their equipment, it still may be at a risk to malfunction and the participant, will take sole responsibility for any injuries that occur during a training session due to equipment use. I also am aware that while participating in Claggett Power Skating Academy’s training sessions on the ice at a rink, that I am at risk of ice or rink malfunctions, and that Claggett Power Skating Academy does not take responsibility for any ice or rink malfunctions and injuries that occur because of said malfunction.

I understand and I am aware that activities, including the use of equipment, are potentially hazardous activities that could put me at risk for the injuries and risks listed under “release of liability and assumption of risk” section of this wavier and I agree to hold Claggett Power Skating Academy harmless, if any injury occurs because of equipment malfunction of any sort.

I am voluntarily participating in activities and using equipment with knowledge of the dangers involved. I understand and take sole responsibility for any and all injuries and changes that may occur to myself or on my behalf. I also verify that I have reliable health insurance or enough means to cover the cost of any emergency or incident of injury or equipment malfunction that occurs and will not rely on Claggett Power Skating Academy to pay for such cost. Although Claggett Power Skating Academy will take precautions to ensure my safety, I expressly assume and accept sole responsibility for my safety and for any and all injuries and changes that may occur.

Conclusion

1. I have requested Claggett Power Skating Academy to conduct hockey based training sessions in a selected location agreed upon with myself and Claggett Power Skating staff.

2. Claggett Power Skating Academy, a local rink, and/or I will provide equipment to be used in connection with our workouts and hockey technique developments, including but not limited to equipment detailed above.

3. I have complete control over the area in which we will perform our workouts. I understand that my equipment or surroundings are at risk for damage during training sessions and am responsible for the repair and payments of any damage or injury that occurs during the training session.


4. I understand by participating in said Activity, that I am aware of the potential risks involved, including the risks listed under the “release of liability and assumption of risk” section of this wavier and agree to hold Claggett Power Skating Academy Harmless if said risk occurs during my activity and training session.

THIS AGREEMENT was entered into at arm’s-length, without duress or coercion, and is to be interpreted as an agreement between two parties of equal bargaining strength. Both Claggett Power Skatting Academy and I agree that this agreement is clear and unambiguous as to its terms, and that no other evidence shall be used or admitted to alter or explain the terms of this agreement, but that it will be interpreted based on the language in accordance with the purpose for which it is entered into. In the event that any provision contained within this Release of Liability shall be deemed to be severable or invalid, or if any term, condition, phrase or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this agreement shall remain in full force and effect. If the court should find that any provision of this agreement to be invalid or unenforceable, but that by limiting said provision it would become valid and enforceable, then said provision shall be deemed to be written, construed and enforced as so limited.

Student:

Emergency Contact:

Signature

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