UAC BASKETBALL

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UAC BASKETBALL WAVIER

PLAYER INFORMATION

* First Name:

* Last Name:

AAU #:

* TEAM NAME:

Gender:

PARENT/GUARDIAN

* Firstname:

* Last name:

* EMail:

* Cell Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

Phone:

Insurance Carrier:

Policy #:

WAIVER INFORMATION

UTAH ATHLETIC CENTER, LLC (“UAC”)
WAIVER OF LIABILITY, ASSUMPTION OF RISK,
AND INDEMNITY AGREEMENT
Waiver. In consideration of permission to use, today and on all future dates, the property
facility and equipment of Utah Athletic Center, LLC (“UAC Facility”), I, for myself, my heirs,
personal representatives or assigns, do hereby release, waive, discharge, and covenant not to sue
UAC, its directors, officers, employees, and agents from liability from any and all claims
including negligence of UAC resulting in personal injury, accidents or illness (including death),
and property loss arising from, but not limited to, individual use and/or participation in activities,
classes, observation, and use of facilities, premises or equipment under the direction and control
of a lessee of the UAC Facility.
_______________________________________ _________________________________
Signature of Parent/Guardian of Minor Date Signature of User Date
Assumption of Risks: Physical activity, by its very nature, carries with it certain
inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. The UAC
Facility involves individual use and activities under the direction and control of a lessee of the
UAC Facility, such as volleyball, basketball, pickle ball, and sporting activities. These activities
involve strenuous exertions of strength using various muscle groups, some involve quick
movements involving speed and change of direction, and others involve sustained physical
activity which places stress on the cardiovascular system.
The specific risks vary from one activity to another, but the risks range from (1) minor
injuries such as scratches, bruises, and sprains; (2) major injuries such as eye injury or loss of
sight, joint or back injuries, heart attacks, and concussions; (3) catastrophic injuries including
paralysis.
Release, Waiver of Liability, and Assumption of Risk. In consideration of the
opportunity afforded Participant to participate in activities in the UAC Facility, Participant
hereby releases and forever discharges UAC from any and all liability, claims, and demands of
whatever kind or nature, either in law or in equity, which arise or may hereafter arise from or in
connection with activities within the UAC Facility. Participant understands that this release
discharges UAC from any liability or claim that Participant may have against UAC with respect
to any bodily injury, personal injury, illness, death, property loss, or property damage that may
result from participation in activities within the UAC Facility. Participant understands and
acknowledges that potential risks to health and personal property may be associated with
participation in the activities, and Participant voluntarily assumes those risks.
Medical Treatment and Preexisting Medical Conditions. Participant hereby releases
and forever discharges UAC from any liabilities, claims, costs and damages that arise or may
hereafter arise on account of any first aid, medical treatment, or service rendered to Participant in
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connection with the activities within the UAC Facility. Participant will take for herself or
himself any appropriate precautions or medications to treat and/or reduce the likelihood of
exacerbating any preexisting health conditions, or insect, food or medication allergies.
I have read the previous paragraphs and I know, understand and appreciate these and
other risks that are inherent in the activities within the UAC Facility. I hereby assert that my
participation is voluntary and that I knowingly assume all such risks.
Indemnification and Hold Harmless. I also agree to indemnify and hold UAC harmless
from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities,
including attorney’s fees brought as a result of my involvement in activities at the UAC Facility
and to reimburse UAC for any such expenses incurred.
Severability. The undersigned further expressly agrees that the foregoing waiver and
assumption of risks agreement is intended to be as broad and inclusive as is permitted by the
laws of the State of Utah and that if any portion thereof is held invalid, it is agreed that the
balance shall, notwithstanding, continue in full legal force and effect.
Other. This release shall be binding and legal enforceable against Participant and
Participant’s heirs, executors, administrators, and legal representatives. This release shall be
governed by and interpreted in accordance with the laws of the State of Utah. In the event that
any clause or provision of this release shall be held to be invalid by any court of competent
jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining
provisions of this release.
Acknowledgement of Understanding. I have read this waiver of liability, assumption
of risk, and indemnity agreement, fully understand its terms, and understand that I am giving up
substantial rights, including my right to sue. I acknowledge that I am signing the agreement
freely and voluntarily, and intend by my signature to be a complete and unconditional release of
all liability to the greatest extent allowed by law.
_______________________________________ _________________________________
Signature of Parent/Guardian of Minor Date Signature of User Date
Participant’s Age (if minor) ________________
Minor Release. And I, the minor Participant’s parent and/or legal guardian, understand
the nature of athletic activities and the minor Participant’s experience and capabilities and
believe the minor to be qualified, in good health, and in property physical condition to participate
in such activity. I hereby release, discharge, covenant not to sue, and agree to indemnify and
save and hold harmless UAC from all liability, claims, demands, losses, or damages on the minor
Participant’s account, caused or alleged to be caused in whole or in part by the negligence of the
“releases” or otherwise, including negligent rescue operations and further agree that if, despite
this release, I, the minor Participant, or anyone on the minor Participant’s behalf makes a claim
against any of the releases named above, I will indemnify, save, and hold harmless UAC from
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any litigation expenses, attorney fees, loss liability, damage, or cost any may incur as the results
of any such claim.
Printed Name of Parent/Guardian:
Address:
(Street) (City) (State) (Zip)
Phone: _____________________________ Date:
Parent/Guardian Signature:
(only if participant is under the age of 18)
4849-9073-1578, v. 1

I/we agree with the above. By checking the box, I assert that I have reviewed and agree to all the waivers and agreements I selected above. *

Signature:

Date:

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UAC BASKETBALL WAVIER