DALLAS YOUTH VOLLEYBALL (DYVB)

WAIVER AND RELEASE OF LIABILITY FORM

NOTE: This form must be read and signed before player listed below is allowed to take part in any training, competition, practice/warm-up sessions, meeting or testing sessions.

I, THE PARTICIPANT, HAVE READ THIS DOCUMENT AND I UNDERSTAND ITS CONTENTS. I acknowledge that volleyball or any sporting event is an extreme test of a person’s physical and mental limits and carries with it the potential for death, serious injury or property loss. With a full understanding of the potential risks, I HEREBY ASSUME THE RISKS OF PARTICIPATING IN OR OFFICIATING A VOLLEYBALL EVENT/PRACTICE. I hereby take the following action for myself, my executors, administrators, heirs, next of kin, successors and assigns: a) I waive, release and discharge from any and all claims or liabilities for death or personal injury or damages of any kind, except that which is a result of gross negligence and/or wanton misconduct of persons or entities listed below, which arise out of or are related to my participation in, or my traveling to and from a volleyball event led by representatives of the following entities: The Dallas Youth Volleyball , any other facility, organization, business and/or organization that allows us to use their gym/equipment, and the coaches or any guest coaches and the officers, directors, employees, representatives, and agents of any of the above; b) I agree not to sue any of the persons or entities mentioned above for any of the claims or liabilities that have waived, released or discharged herein; c) I indemnify and hold harmless the persons or entities mentioned above from any claims made or liabilities assessed against them as a result of my actions.

THE PARENT/GUARDIAN HAS READ AND COMPLETED AND UNDERSTAND I hereby

executes the foregoing Waiver and Release for and on behalf of the minor named herein. I hereby

bind myself, the minor and all other assigns to the terms of the Waiver and Release. I represent

that I have legal capacity and authority to act for and on behalf of the minor named herein, and I

agree to indemnify and hold harmless the persons or entities mentioned above for any claims or

liabilities assessed against them as a result of any insufficiency of my legal capacity or authority to !

act for and on behalf of the minor in the execution of the Waiver and Release.

________” I have voluntarily enrolled in The Dallas Youth Volleyball DYVB & Dallas Volleyball School ball and understand all the risks associated with participation in this program. I recognize that the program may involve strenuous physical activity including, but not limited to muscle strength and endurance training, cardiovascular conditioning and training, and other various fitness activities. I hereby affirm that I am in good physical condition and do not suffer from any known disability or condition which would prevent or limit my participation in this Volleyball program. I acknowledge that my enrollment and subsequent participation is purely voluntary.”

________” I, the undersigned, waive and release he Dallas Youth Volleyball DYVB & Dallas Volleyball , its directors, coaches, staff, independent contractors, he Dallas Youth Volleyball DYVB and its employees, volunteers, staff and representatives from any and all liability, claims, demands, and causes of action arising out of or related to any loss, personal injury (including death), disease, illness, or property loss that may be sustained or occur from participation in or otherwise be associated with the Dallas Youth Volleyball DYVB

________ “In consideration of my participation in this program. I hereby release VanEssa Kerecman, NEPA Elite Volleyball Club LLC & DYVB , or its trainers/agents from any claims, demands, and cause of action as a result of my voluntary participation and enrollment.”

________ “I fully understand that my child can injure their as a result of my enrollment and subsequent participation in this program and I hereby release / DYVB and it's trainers/agents from any liability now or in the future for conditions that I may obtain. These conditions may include, but are not limited to heart attacks, muscle strains, muscle pulls, muscle tears, broken bones, shin splints, heart prostration, or any other illness, injury or soreness that I may incur, including death.”

I have read the club rules and expectations and agree to adhere to them.

I understand that valuables are brought to practice, tournaments etc are at its own risk. Any personal items lost or stolen will not be replaced byDYVB ..

I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during camp.

I understand that players may be photographed / Video clips during the club. I agree to allow undersigned players photos or videos to be used for legitimate purposes by the DYVB . In any promotional materials players would not need to be identified by name.

I have read and fully understand this release of liability. I sign it of my own free will.

I understand all the risks associated with participation in this program. I certify that the undersigned camper is physically capable of participating in the DYVB and all related activities. Exceptions are noted on the medical form.

is physically fit to participate in all activities at the volleyball practice and matches, and has had a recent physical exam.

Dallas Volleyball DYVB Release and Waiver of Liability: I understand that playing or participating in the above sport(s) may be a potentially dangerous activity with the risk of injury. I understand that in any contact sport, such as the sport involved at this camp, an athletic participant can be seriously hurt.

I am aware that the dangers and risk of my child/ward playing or participating in the above sport include, but are not limited to, falls, contact or collisions with other participants, equipment and facilities and the effects of weather, including heat and humidity. I understand that my child/ward may incur a serious injury including paralysis or death, as a result of the dangers and risks associated with the above sport(s). I have certified to the coach, by my signature below, that my child is in good health and physical condition and sufficiently able to participate in the camp. I understand that the coach recommends that my child/ward obtain a physical examination to identify any physical condition or limitation of which I might not be aware that could affect her participation in the above named sport(s). I have advised the coach of any limitations on my child/ward’s activities for medical reasons.

Knowing and having been informed of the potential dangers and risks associated with playing the above sport(s), and in consideration of my child/ward being allowed to participate in the camp, I hereby agree on behalf of myself, my family members and my child/ward to assume all such risks and further, to waive, release, discharge and hold harmless DYVB and their respective employees, coaches, camp instructors and volunteers from any and all liability actions, causes of actions, claims or demands for personal injury, death or property damage of any kind or nature, and any other claim whatsoever arising out of, or in any way connected with my child/ward playing and participating in the above sport and camp. This Release and Waiver extends to all claims of every kind or nature whatsoever, foreseen or unforeseen, known or unknown. The terms hereof shall serve as an assumption of risk, release and waiver for myself, my family, my child/ward and our heirs, executors, administrators, guardians or anyone else who might assert a claim on our behalf.

I hereby consent to permit the coach and staff working at the camp to provide emergency first-aid or medical treatment for my child/ward according to their best judgment, in the event he/she suffers an injury or illness while participating in the camp or on the camp premises.

I HEREBY AFFIRM THAT I HAVE READ AND FULLY UNDERSTAND THE ABOVE

PHOTOGRAPHY RELEASE

I hereby agree to allow DYVB and Dallas . to record and publish photos and videos (including audio) of myself for the purpose of promoting Dallas Volleyball & DYVB . I understand photographs, video and/or audio tape recordings to be taken of myself and/or family members at practice, during competition, recreational play, as well as other related events at / DYVB . I understand that this media will be produced and used for promotional purposes and I authorize Dallas Volleyball & DYVB to use my/our photographs, video and/or audio recordings on its website and social media platforms, such as Facebook , Twitter, YouTube, Instagram, Snapchat, etc., as well as other printed publications without further consideration. In addition, I acknowledge Dallas Volleyball & DYVB, Inc.'s DYVB right to crop or treat the media at its discretion, and I also acknowledge that Dallas Volleyball & DYVB may choose not to use my/our image at this time but may do so as its own discretion at a later date.

I also understand that once I, or my family members, image(s) have been captured, they may be posted on DYVB Dallas Volleyball websites or social media platforms, the image may be downloaded by any computer user on or off the premises of NEPA Elite Volleyball Club Event or Practice or . facilities. Dallas Volleyball & DYVB also reserves the right to discontinue use of photos without notice.

Dallas Youth Volleyball

Dallas Middle Volleyball