ULTIMATE CHAMPIONSHIPS - LIABILITY RELEASE & WAIVER FORM
ALL PARTICIPANTS MUST FILL OUT THIS MEDICAL RELEASE FORM/S BEFORE THEY MAY COMPETE AT AN EVENT.
Every participant must have an original, completed, and signed release form to turn in at check-in to participate.
Squad members who do not turn in fully-completed forms will not be allowed to compete (no refunds).

arrow&v

Liability Release: For good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged,

I                                                             , as a parent or guardian of

minor (hereinafter "Minor"), hereby grant the permission necessary to allow Minor to participate in the above event to be conducted by The Ultimate Championships. I, in my own behalf and on behalf of Minor, further agree to release and to hold harmless Ultimate Championships (hereinafter "Sponsors"), the Hosting site, (convention center, hotel, high school, university) on whose premises the Event will occur (hereinafter the "Location"), the affiliates of Ultimate Championships and the Location, and the respective directors, officers, representatives, members, agents and employees of Ultimate Championships, Sponsors, the Location and their respective affiliates (hereinafter collectively "Releasees") from any and all liability whether caused by negligence of the Releasees or otherwise for any claim, judgment, loss, liability, cost and expenses (including, without limitations, attorney's fees and costs) arising out of or connected with the Event, including any claim arising out of or connected with any illness or injury (minimal, serious, catastrophic and / or death) that Minor may incur or sustain during the Event, all activities associated with the Event and while traveling to and from the site for the Event whether or not the Event actually occurs. I further expressly agree to indemnify and hold harmless Releasees and Releasees' heirs, successors, assigns, executors and administrators against loss from any further claims, demands or actions that may subsequently be brought by Minor or by any other persons on the account of damages of any character resulting to Minor in any way from the foregoing activities. I further agree to reimburse and to make good to Releasees any loss or costs Releasees may have to pay as a result of any such action, claim or demand.
I                                                                , in my own behalf and on behalf of Minor, hereby warrant that I have read this Liability Release in its entirety and fully understand its contents. I, in my own behalf and on behalf of Minor, am aware that this Liability Release releases Releasees from liability and contains an acknowledgment of my voluntary and knowing assumption of the risk of injury or illness. I, in my own behalf and on behalf of Minor, further acknowledge that nothing in this Liability Release constitutes a guarantee that the Event will occur. I, in my own behalf and on behalf of Minor, have signed this document voluntarily and of my own free will. Minor and I understand that Sponsors may distribute samples of their products at camp.

Supervision: A chaperone/Adult (age 21 and over) is required to attend with participants. This Chaperone will be responsible for the participants at all times. The Ultimate Championships, Ultimate Championship Staff are not responsible for participants' supervision.


Appearance Agreement: I understand that The Ultimate Championships from time to time produces promotional material relating to its programs. I understand that as a participant and/ or a spectator at the Event that Minor may be included in social post taken during the Event. 


Medical Release: I, in my own behalf and on behalf of Minor, acknowledge and agree that such participation subjects Minor to the possibility of physical illness or injury (minimal, serious, catastrophic, and/ or death) and that I, in my own behalf and on behalf of Minor, acknowledge that Minor is assuming the risk of such illness or injury by participating in the event. In the event of such illness or injury, I authorize The Ultimate Championships to obtain necessary medical treatment for Minor and hereby, in my own behalf and on behalf of Minor, release and hold harmless Releasees in the exercises of this authority. I further acknowledge and understand that I will be responsible for any and all medical and related bills that may be incurred on behalf of Minor for any illness or injury that Minor may sustain during the Event and while traveling to and from the site for the Event whether or not the Event actually occurs.
I represent that any medication to which Minor is allergic or medications that Minor is currently taking are listed below. I agree that Minor shall bring medications which Minor is currently taking with him/her to the Event and that he/she shall consume the prescribed dosage for such medications.

I, in my own behalf and on behalf of Minor, hereby warrant that I have read this Participant Release and Waiver Form in its entirety and fully understand its contents. I, in my own behalf and on behalf of Minor, am aware that this Participant Release and Waiver Form releases Releasees from liability and contains an acknowledgment of my voluntary and knowing assumption of the risk of injury or illness. I, in my own behalf and on behalf of Minor, further acknowledge that nothing in this Participant Release and Waiver Form constitutes a guarantee that the Event will occur. I, in my own behalf and on behalf of Minor, have signed this document voluntarily and of my own free will. Minor and I understand that Sponsors may distribute samples of their products at the event.

Helpful for quick verification of insurance policy by hospital/clinic

Your content has been submitted

Havert Fenn Center

An error occurred. Please look over form for required information.