Yearly Athletic Participant Agreement, Waiver & Release Form

This completed and signed form MUST be completed for each participant before the first sports activity. SWBIBLE requires all participants to yearly renew their information and have a form on file with the Athletic Department.
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Participant's Name *

First & Last
 
Date of Birth *

 
Address *

 
City *

 
ZIP *

 
Gender *


 
Age *

 
Home Phone #

 
Work Phone #

 
Cell Phone #

 
Name of emergency contact *

 
Emergency Phone # *

 
Doctor's Name *

 
Insurance carrier/number *

 
Special medical conditions

(allergies, etc.)
 
I would like my waiver to cover any SWBIBLE Athletic Ministry activities that I participate in. *

     
 
Agreement, Waiver & Release

In consideration for being permitted by SWBIBLE to participate in its athletic ministries, I hereby waive, release, and discharge any and all claims for damage for personal injury, death or property damage which I may have, or which may hereafter accrue to me, as a result of participation in said activities. This release is intended to discharge in advance SWBIBLE (its officers, employees, and agents) from any and all liability arising out of or connected in any way with my participation in said activities, even though that liability may arise out of negligence or carelessness on the part of the persons or entities mentioned above. It is understood that this activity involves an element of risk and danger of accidents and knowing those risks I hereby assume those risks. It is further agreed that this waiver, release and assumption of risk is to be binding on my heirs and assigns. I agree to indemnify and to hold the above person or entities free and harmless from any loss, liability, damage, cost, or expense which they may incur as the result of my death or any injury or property damage that I may sustain while participating in said activity.
 
I HAVE CAREFULLY READ THIS AGREEMENT, WAIVER, AND RELEASE AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN MYSELF AND SWBIBLE AND I SIGN IT OF MY FREE WILL. *

By entering your name below, you are agreeing to the above statement.
 
Parent/Guardian Consent

By typing your full name, you hereby consent that your son/daughter participate in the ministry activities at SWBIBLE, and you hereby execute the Agreement, Waiver, and Release on his/her behalf. You state that said minor is physically able to participate in said activities. You hereby agree to indemnify and hold the persons and entities mentioned above free and harmless from any loss, liability, damage, cost, or expense that they may incur as a result of the death or any injury or property damage that said minor may sustain while participating in said activities.
 
Relationship to Participant

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