
Fall Mini Clinic
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Liability Form
I am voluntarily participating in physical exercise that can be strenuous and subject to risk of serious injury during PRIVATE OR GROUP TRAINING. Salem Jump Rope ensures that you consult with your guardian before participating in these sessions. You agree that by participating in these physical exercise sessions or personal training activities, is at your own risk. I recognize that exercise is not without some risk to the musculoskeletal system (e.g. sprain, strain) and cardiorespiratory system (e.g. dizziness, fainting, abnormal heartbeat, discomfort in breathing, abnormal blood pressure response, and in rare instances, heart attack or stroke). I acknowledge that not all risks can be known in advance.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 or causes of action of any kind arising out of my participation in the Activity.I HEREBY release and forever discharge Salem Jump Rope, 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.Accident Insurance - Participants are responsible for their own accident insurance when participating in Salem Jump Rope programs.Medications – Salem Jump Rope does not normally administer any medication and will do so only when directed in writing by the child’s parent or guardian. However, in the event of an emergency in which the parent cannot be contacted, Emergency Medical Staff and the Salem Jump Rope may take appropriate action in the best interest of the child.Refunds - I understand that non-attendance does not entitle me a refund. I understand that no refunds or adjustments are granted for illness, vacation or when Salem Jump Rope programs are cancelled due to inclement weather. All refunds or program credits given for other reasons are issued on a prorated basis. I understand that the Salem Jump Rope reserves the right to apply any credit due to other outstanding balances. Refunds are issued within 45 days of cancellation. No refunds will be issued for cancellations received after the start of the program. Sportsmanship - As a parent or legal guardian, I understand that the SalemJump Rope program is an instructional and fun club/clinic representing skill development, positive values and good fellowship. I will support the Salem Jump Rope goals, as well as the coaches and volunteers in teaching these values.Proper attire – Tennis shoes (athletic & supportive footwear) are expected each day. No boots, flip flops, crocs, sandals or dress shoes are allowed. Pick-up – It is expected that a parent or listed guardian be on-time to pick up any student-athletes. If you are late you may jeopardize your child’s further participation in the jump rope clinic/camp/team. In its practices, Salem Jump Rope does not discriminate on the basis of race, creed, disability, national or ethnic origin. I have read and understand all the policies stated above.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 fees and any related costs.I FURTHER ACKNOWLEDGE that Releasees are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf of Releasees. In the event that I should require medical care or treatment, I authorize Salem Jump Rope to provide all emergency medical care deemed necessary, including but not limited to, first aid, CPR, the use of AEDs, emergency medical transport, and sharing of medical information with medical personnel. I further agree to assume all costs involved and agree to be financially responsible for any costs incurred as a result of such treatment. I am aware and understand that I should carry my own health insurance. In the event that any damage to equipment, field or facilities occurs as a result of my or my family’s or my agent’s willful actions, neglect or recklessness, I acknowledge and agree to be held liable for any and all costs associated with any such actions of neglect or recklessness. Both participant and Salem Jump Rope agree that this agreement is clear and unambiguous as to its terms, and that no other evidence shall be used or admitted altering or explain the terms of this agreement, but that it will be interpreted based on the language in accordance with the purposes for which it is entered into.
