WATERLOO'S OWN PickupHub Youth Program Waiver

RELEASE OF LIABILITY, WAIVER OF CLAIMS, ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT FOR WATERLOO’S OWN PICKUPHUB ACTIVITIES/EVENTS. BY COMPLETING THE DOCUMENT BELOW YOU ARE AGREEING TO THE TERMS OUTLINED BELOW:

In consideration of the use of the property, facilities, equipment and/or services of the City of Waterloo or any associated or affiliated individuals, corporations, or organizations, the undersigned agrees as follows:


1. AGE OF MAJORITY

I am at least 18 years old, and have legal authority to authorize my son / daughter / child in care to participate in Waterloo’s own PickupHub.


2. ACKNOWLEDGEMENT OF RISK FACTORS

I am aware and acknowledge that participating in indoor and/or outdoor social and sporting activities offered or organized by or associated with The City of Waterloo and using any equipment or services provided by The City of Waterloo including, but not limited to, sports such as dodgeball, ultimate frisbee, slo-pitch, basketball, soccer, beach volleyball, indoor volleyball, ball hockey, ice hockey, tournaments and all of their associated activities, exposes me to many inherent risks, dangers and hazards such as the RISK OF PROPERTY DAMAGE, BODILY INJURY, AND POSSIBLE DEATH.


3. ASSUMPTION OF RISK

By engaging in any activities offered by or associated with The City of Waterloo, I freely accept and fully assume all inherent risks on behalf of my son / daughter / child in care, dangers and hazards and the possibility of personal injury, death, property damage or loss resulting not only from the activity itself but which might result from the use of equipment or facilities, from the acts of others, or from the unavailability of emergency medical care.


4. RELEASE OF LIABILITY - WAIVER OF CLAIMS & INDEMNITY AGREEMENT

In consideration of The City of Waterloo permitting my son / daughter / child in care to participate in its activities and sports, permitting me to the use of its equipment and permitting me the use of its facilities, I hereby agree as follows:
4.1 To waive any and all claims that I have or may in the future have against The City of Waterloo, and its directors, employees, agents and representatives, resulting from my activities and my participation in the activities offered through Waterloo’s Own PickupHub.
4.2 To release The City of Waterloo, and its directors, officers, employees, agents and representatives from any and all liability for any loss, damage, injury or expense that I may suffer or that my next of kin may suffer, as a result of my participation in activities and sports offered by The City of Waterloo, due to any cause whatsoever including negligence, breach of contract, breach of statutory duty of care, and/or any breach arising under the Occupier's Liability Act, R S 0 1990, C.O 2, and as amended from time to time, on the part of The City of Waterloo and its directors, officers, employees, agents and representatives.
4.3 To hold harmless and indemnify The City of Waterloo, and its directors, officers, employees, agents and representatives from any and all liability for any property damage, personal injury, or damages for economic loss suffered by any third party, resulting from my activities and my participation in the activities offered by or associated with The City of Waterloo.
4.4 That this Agreement shall be effecting and binding upon any heirs, next of kin, executors, administrators and assigns in the event of my death.

5. SPORTSMANSHIP AND FAIR PLAY AGREEMENT

5.1 I have read, understood and will abide by the rules of my activity as outlined by The City of Waterloo.
5.2 I understand that in all self-officiated activities I am responsible to call my own fouls. I will not wait for my opponent or The City of Waterloo staff person (if present) to make that decision.
5.3 I understand that if it is reported by a City of Waterloo staff person, Official or an opponent that I have behaved in an unsporting manner or have not played by the rules, that I could be suspended or ejected from the activity, with no refund with further participation in similar activities being suspended or removed.


I accept the terms of this waiver


Yes (Check the box or circle if mannual)

Parent Name: __________________________________ Date: _________________________

Childs Name: __________________________________