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Participant Waiver and Release from Liability Form
Participant’s Name_________________________ Parent or Legal Guardian Name___________________
I, the above Participant being above age 18, or the Parent or Legal Guardian of the above participant who is under
age 18, agree as follows:
1. Participant has no medical issue that limits his/her ability to participate in Stay in Play Recreation,
LLC’s (“Stay in Play”) sports program. Participant understands the risks inherent in recreational sports activities
and declares that he/she is healthy and capable of participation Stay in Play’s recreational activities.
2. Recreational sports are a test of a person’s physical, mental, and emotional limits, and that the risk of
injury from such activities involved in this program is significant, including the potential for serious injury, and
while specific rules, equipment, and personal discipline may reduce this risk, the risk of serious injury is present.
3. Participant knowingly and freely assumes all such risks, both known and unknown, even if arising from
the negligence of Stay in Play, the City of Akron, other participants, spectators, or others, and assumes full
responsibility for participation.
4. Participants knowingly accepts all risk associated with the location of the recreational sporting site.
Including known and unknown hazards of the venue and surrounding area.
5. Participant consents and authorizes Stay in Play to obtain any necessary medical treatment or
hospitalization or such other care necessary for Participant’s health and welfare, and agrees to be responsible for and
pay the costs of such medical treatment or hospitalization.
6. To the fullest extent of the law, Participant WAIVES, RELEASES AND DISCHARGES Stay in Play
and the City of Akron from any and all claims or liabilities from personal injury, accident, illness, death, property
loss of any kind arising during, before or after activities operated by Stay in Play, including Participant’s travel to
and from and/or participation in any sporting event. Participant further agrees to hold harmless Stay in Play and the
City of Akron from any and all claims, suits or other liabilities.
PARTICIPANT AND PARENT/GUARDIAN HAS READ THIS RELEASE OF LIABILITY AND
ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTANDS ITS TERMS, UNDERSTANDS THAT
PARENT AND PARTICIPANT HAS GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING THIS RELEASE
OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, AND SIGN IT FREELY AND
VOLUNTARILY WITHOUT ANY INDUCEMENT.
______________________________________ DATE: _____________________________
(PARTICIPANT)
______________________________________ DATE: _____________________________
(PARENT/GUARDIAN SIGNATURE)
Contact Information
Daytime Phone: ____________ Evening Phone: _____________ Emergency Contact: ________________
Participant’s Date of Birth (MM/DD/YY) _________________ Driver’s License________________________
Rubber City Sports
Rubber City Sports
Rubber City Sports