VAVI
Sport & Social Club
Waiver Form
CONTRACT FOR VOLUNTARY PARTICIPATION IN VAVi LLC
RECREATIONAL SPORTS ASSUMPTION OF INJURY RISKS
There is a risk of injuries,
both serious and minor, associated with participation in any VAVi LLC Sport.
The risks may increase in activities involving physical contact, running,
jumping or otherwise leaving one's feet, diving, sliding, or interaction with
moving objects that are thrown or otherwise used in the sport. The risks
include, but are not limited to: injury to the head, neck, or spine (including
paralysis); injury to the muscular or skeletal systems; injury to internal or
external organs; loss of or damage to sight, hearing, or teeth; death; long or
short-term disability; loss of income, career opportunities, or the enjoyment
of life; pain; and scarring or disfigurement.
IT IS THE
RESPONSIBILITY OF EACH INDIVIDUAL PARTICIPANT to know his or her own general
state of health and well-being, and therefore to be able to certify
knowledgeably that he or she is physically fit to participate in a VAVi LLC
Sport.
IT IS ALSO THE
RESPONSIBILITY OF EACH INDIVIDUAL PARTICIPANT to have health insurance coverage
sufficient to provide for medical or dental services and/or equipment required
to treat any injury, minor or catastrophic, sustained or incurred as a result
of participating in VAVi Sports leagues, and to certify that such insurance
coverage is held.
Therefore, AS A
PRECONDITION TO BEING GRANTED PERMISSION TO PARTICIPATE IN ANY VAVi LLC SPORT,
EACH PARTICIPANT shall read the agreement set forth below in order to make an
educated choice to participate or not participate. Your signature will signify
your recognition of the possible health risks involved and your informed
consent to them.
To that end, and
before releasing VAVi LLC from all actions, claims, or demands related to any
injury you may sustain as a result of participating in its VAVI LLC Sports
leagues, please give serious consideration to the possible ramifications. You
should understand that the causes of possible injury are many, but among them
are: injury from bodily contact, incidental to or inherent in the nature of the
sport; slipping, falling, or tripping on the playing surface, regardless of its
physical or environmental conditions; injury from warming up, practicing, or
training for game participation; injury due to supervision by VAVi employees,
paid or unpaid, including referees or officials, or to rules, regulations, and
instructions (or lack thereof) regarding the use of game equipment or tools or
to the nature of the game itself, particularly in contact VAVi Sports; or
injury due to a disparity between and among other players or teams with respect
to experience level, strength, height, weight, age, ability, and the relative
competitiveness or maturity of, between, or among other participants.
FAILURE TO COMPLETE
THIS FORM IN ITS ENTIRETY WILL RESULT IN THE EXPULSION OF BOTH THE INDIVIDUAL
AND HIS/HER TEAM FROM VAVi SPORTS.
I
_______________________________ have read the above ASSUMPTION OF INJURY RISKS
IN VAVi SPORTS and understand its contents. I acknowledge the risk of injury
that may result from participation in VAVi LLC Sports leagues and am willing to
and hereby do voluntarily assume all risks of harm associated with my
participation.
I certify that to
the best of my knowledge, I am physically fit and able to participate in VAVi
LLCSports, that I am in good health, and that I am unaware of any medical
condition, which might make my participation inadvisable. (initials) X
__________
I am aware that
participating in VAVi LLCSports may expose me to a risk of injury, minor or
serious, including those listed above in ASSUMPTION OF INJURY RISKS IN CLUB
SPORTS. I accept and assume all risks, known or unknown, listed or unlisted,
that may result from my voluntary participation in VAVi LLC Leagues or in
activities related to such sports, regardless of the cause of the injury.
(initials) X __________
I acknowledge my
responsibility to acquire health insurance coverage sufficient to provide for
all medical or dental services and/or equipment required to treat any injury,
minor or catastrophic, related to my participation in VAVi LLC Sports Leagues,
AND HEREBY CERTIFY that on the date noted below, I have such insurance coverage
in effect. (initials) X __________
In consideration of
VAVi LLC permitting me to participate in its Sports Leagues, I knowingly and
intentionally give up any legal right that I, my heirs, or legal
representatives have or may have againstVAVi, its trustees, officers, agents,
employees, the City of San Diego, or insurers, from any action, claim, or
demand that I, my heirs, or my legal representatives have or may have for any
and all personal injuries I may suffer or sustain, regardless of cause or
fault, on- or off-the field, as a result of my voluntary participation in VAVi
Sports Leagues and/or in other activities related thereto. (initials) X
__________
I knowingly intend
my signature on this Agreement to be a complete defense to any legal proceeding
that may be brought by anyone on their own or on my behalf for any injury I may
suffer or sustain as a result of voluntarily participating in VAVi Sports
Leagues or in activities related thereto, and further intend this Agreement to
be a complete and total release of liability for all negligent acts, failures
to act, or breaches of duty owed to me, which result in my personal injury or
death as a result of my voluntary participation in VAVi Sports Leagues.
(initials) X __________
I certify that I am
18 years of age or older, that I am legally competent and capable of executing
this Agreement on my own behalf, that I have read the foregoing and have made a
conscious decision to sign it of my own free will.
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