Cheer Waiver and Release

(Adult Participant - 18 years or older)

 

 

Name:  _________________________________________

 

Address:  _______________________________________

 

Age:  ______      Birth Date:  _______________________

 

School:  ________________________________________

 

In case of emergency notify:

 

Name:  _________________________________________

 

Phone:  _________________________________________

 

 

            I certify that I am physically able to participate in this event. I will be voluntarily engaging in activities which involve risk of injury, scarring, disability, or death.  Such injury may result not only from my own action, inaction, and/or negligence, but also the actions of others, the nature of the event, the conditions of the premises, or the equipment used.  There may also be other risks not known or reasonably foreseeable at the time.  I assume all of the foregoing risks and accept personal responsibility for any damages following injuries, disabilities, or death.  Further, in consideration of acceptance of my entry into the event, I, on behalf of myself, heirs, administrators, and assigns, hereby release, waive, and discharge the organizers of the event, including but not limited to, the Blair County Respiratory Disease Society, its employees, agents, board members, advisors, insurers, and the event sponsors, as well as the Altoona Area School District, from any and all claims, damages, demands, and actions whatsoever in any manner arising from my participation in this event.

 

____________________________________

Signature of Participant                         Date       

 

            I acknowledge that photographs, videos, and/or digital images may be taken throughout the event.  I authorize my image to be taken and used for informational and promotional purposes without compensation to me, my heirs, assigns, and/or administrators

 

____________________________________

Signature of Participant                         Date