BIG WHEEL
ROLLER HOCKEY LEAGUE 2007-2008 SEASON
MAILING ADDRESS:
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MOTHERS NAME:______________________OCCUPATION:____________________________________
SCHOOL ATTENDING:_________________ GRADE:__ ______
AMOUNT PAID_____________DATE____________________DIVISION_____________SESSION________________
AMOUNT
PAID_____________DATE____________________DIVISION_____________SESSION________________
WAIVER AND RELEASE OF LIABILITY - POCONO B.W., INC. & ANY AFFILIATES
(HEREAFTER REFERRED TO AS “BIG WHEEL”)
In consideration of being
allowed to participate in any sports programs and other sponsored activities
offered
by Big Wheel,
the undersigned acknowledges and agrees as follows:
1. I acknowledge and fully understand that I will be engaging in
activities that involve risk of serious injury, including
permanent
disability and death and severe social and economic losses, which might result
not only from my own actions,
inactions, or
negligence, but also from the actions and inactions or negligence of others,
the rules of play, or the condition
of the premises or
competition area or any equipment used, further, that there may be other risks
not known to me or
reasonably foreseeable at this time.
2. I agree that prior to participating in any
activity sponsored by Big Wheel, I will inspect the competition area and
all equipment
to be used, and if through my inspections, I determine that anything related to
that activity is unsafe,
I will immediately advise my coach or an
official of Big Wheel of this unsafe condition and will not participate until
the condition
is corrected.
3. I
assume all foregoing risks and accept personal responsibility for the damages
following such injury, permanent
disability or death.
4. I release, waiver, discharge, and covenant not to sue Big Wheel, it’s
affiliated clubs, their respective administrators,
directors, agents, attorneys, coaches, and other employees of
the organization, other participants, sponsoring agencies
sponsors,
advertisers, and if applicable, owners and lessors of
premises used to conduct the event, all of which are
hereinafter
referred to as “releases”, from demands, losses or damages on account of
injury, including death or damage
to property,
caused or alleged to be caused in whole or part by the negligence of the
release or otherwise.
5. If any sessions are canceled for any reason,
whatsoever, Big Wheel will reschedule at an available time. If no time
is made
available, then the portion of the session unused shall be refunded.
I have
read the above waiver and release and understand that I have given up
substantial rights by signing it
voluntarily. I also agree to abide by all rules of the Big
Wheel Indoor Sports Leagues as outlined in the application,
flyer and/or B.W.F.R.H.L rulebook.