Wavier & Release of Liability

In consideration of being allowed to participate in any way in U.S. Synchronized Swimming ("USA Synchro") and NoVa Synchro of Virginia, Inc., practices, events, activities, or programs, I acknowledge and agree that:

1. I understand that I or (if the participant is a minor) my child or ward, will be engaging in travel and activities that involve the risk of serious injury, including permanent disability and death, severe social and economic losses and other loss including damage to property.

2. I knowingly and freely assume all such risks.

3. I, for myself, my minor child or ward, and on behalf of my and their heirs and assigns, release, waive, discharge and covenant not to sue NoVa Synchro of Virginia, Inc. or U.S. Synchronized Swimming, Inc., its officers, agents, employees, contractors, and sponsors as well as its affiliate clubs, from any and all liability for any and all claims, demands, losses or damages on account of injury, including death and damage to property, whether caused by negligence or otherwise.

MEDICAL RELEASE

I authorize all medical and surgical treatment, X-ray, laboratory, anesthesia, and other medical and/or hospital procedures as may be performed or prescribed by the attending physician and/or paramedics for my swimmer and waive my right to informed consent of treatment. This waiver applies only in the event that neither parent/guardian of the minor child or ward can be reached in the case of an emergency or if a swimmer over the age of 18 is incapacitated and unable to provide consent.

 

Child’s Name (Print)____________________________________Age______________

 

*If athlete is less than 18 years of age, the parent or legal guardian must also sign below. This is to certify that, as parent/guardian of this participant; I do consent to his/her waiver and release as set forth above and also agree to assume all such risks and to waive the right to sue the releases.

 

Parent/Guardian Signature _______________________________Date_____________

 

Parent/Guardian Name (Print) ______________________________________________

 

Email_______________________

 

Telephone____________

 

Relationship ____________