Parents Full Name: (required)

Name of Son or Daughter:(required)

Parents Email:(required)

Parents Cell #:(required)

Parents Work #:

Parent Address:

Referral Source:

Player’s Insurance Company Name:

Insurance Policy #:

Member Name:

Member ID#:

Group #:

Effective Date:

Insurance Expiration Date:

Member Services Phone #:

Emergency Contact Phone #:

Allergies:

Disclaimer:

SAND SOUL BEACH VOLLEYBALL CLUB LLC WAIVER AND RELEASE OF LIABILITY

By indicating your acceptance, you understand, agree, warrant and covenant as

follows:

SAND SOUL BEACH VOLLEYBALL CLUB LLC PARTICIPANT WAIVER AND RELEASE

OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT for ADULTS

(Age 18 or older) and MINORS (age 17 and under)

THIS WAIVER AND RELEASE OF LIABILITY, ASSUMPTIONS OF RISK AND

INDEMNITY AGREEMENTS APPLIES TO YOUR PARTICIPATION IN THE SAND SOUL

BEACH VOLLEYBALL CLUB TRAINING, PRACTICE AND COMPETITION SESSIONS,

IN HUNTINGTON BEACH AND NEWPORT BEACH, CALIFORNIA, OVER THE

BEACHES AND FACILITIES THERE OF, OR ANY EVENT OUTSIDE OF SUCH AREA AT

THE DIRECTION OF Sand Soul Beach Volleyball Club the “Event”). THIS APPLIES TO

THE EVENT ITSELF AND TO ALL RELATED ACTIVITIES INCLUDING PRE AND POST

EVENT ACTIVITIES, AS WELL AS OFF-SITE TRAINING SESSIONS UNDER SAND

SOUL BEACH VOLLEYBALL CLUB LLC DIRECTION.

For and in consideration of Sand Soul Beach Volleyball Club LLC allowing the

undersigned to participate in the Event identified above as a player and/or volunteer; I,

for myself, and on behalf of my spouse, children, guardians, heirs and next of kin, and

any legal and personal representatives, executors, administrators, successors and

assigns, hereby agree to and make the following contractual representations pursuant

to this Waiver and Release of Liability, Assumption of Risk and Indemnity Agreement

(the “Agreement”). If I am an adult signing on behalf of a minor (the “Minor”) I make the

same contract on behalf of that Minor and all of the same persons or entities related to

or representing that Minor: I further represent, warrant and guarantee that I have full

legal and moral authority to sign this Agreement on behalf of the Minor and to thereby

relinquish substantial legal rights on behalf of the Minor.

  1. I hereby represent that (i) I am at least eighteen (18) years of age or older; (ii) I am in

good health and in proper physical condition to participate in the Event, have trained

for the Event and have not been advised by a health professional to not undertake this

or similar volleyball events and (iii) I am not under the influence of alcohol or any illicit

or prescription drugs which would in any way impair my ability to safely participate in

the Event. I agree that it is my sole responsibility to determine whether I am sufficiently

fit and healthy enough to participate in the Event, that I am responsible for my own

safety and well-being at all times and under all circumstances while at the Event site. If

I am signing this Agreement on behalf of a Minor I am making the same representations

for and on behalf of that Minor.

  1. I understand and acknowledge that participation in this Event is inherently

dangerous as it is an athletic event. As such, the Event represents an extreme test of a

person’s physical and mental limits. I understand and acknowledge the risks and

dangers associated with participation in the Event, including without limitation, the

potential for serious bodily injury, sickness and disease, permanent disability, paralysis

and loss of life; loss of or damage to equipment/property; exposure to extreme

conditions and circumstances; contact with other participants, spectators, animals or

other natural or manmade objects; dangers arising from adverse weather conditions;

imperfect course or track conditions; land, water and surface hazards; equipment

failure; inadequate safety measures; participants of varying skill levels; situations

beyond the immediate control of the Event Organizers; and other undefined, not readily

foreseeable and presently unknown risks and dangers (“Risks”). I understand that

these Risks may be caused in whole or in part by my own actions or inactions, the

actions or inactions of others participating in the Event, or the negligent acts or

omissions of the Released Parties defined below, and I hereby expressly assume all

such Risks and responsibility for any damages, liabilities, losses or expenses which I

incur as a result of my participation in any Event. If I am signing this Agreement on

behalf of a Minor I am making the same representations and assuming the same risks

for and on behalf of that Minor.

  1. I hereby Release, Waive and Covenant Not to Sue, and further agree to Indemnify,

Defend and Hold Harmless the following parties: Sand Soul Beach Volleyball Club LLC

and its owners, members and coaches; all Venue and Property Owners or Operators

upon which the Event takes place; and each of their respective parent, subsidiary and

affiliated companies, officers, directors, partners, shareholders, members, agents,

employees and volunteers (Individually and Collectively, the “Released Parties” or

“Event Organizers”), with respect to any liability, claim(s), demand(s), cause(s) of action,

damage(s), loss or expense (including court costs and reasonable attorneys’ fees) of

any kind or nature (“Liability”) which may arise out of, result from, or relate in any way

to my participation in the Event, including claims for Liability caused in whole or in part

by the negligent acts or omissions of the Released Parties. I further agree that if,

despite this Agreement, I, or anyone on my behalf, makes a claim for Liability against

any of the Released Parties, I will indemnify, defend and hold harmless each of the

Released Parties from any such Liabilities which any may be incurred as the result of

such claim. I hereby warrant that I am of legal age and competent to enter into this

Agreement, that I have read this Agreement carefully, understand its terms and

conditions, acknowledge that I will be giving up substantial legal rights by signing it

(including the rights of my spouse, children, guardians, heirs and next of kin, and any

legal and personal representatives, executors, administrators, successors and assigns),

acknowledge that I have signed this Agreement without any inducement, assurance or

guarantee, and intend for my signature to serve as confirmation of my complete and

unconditional acceptance of the terms, conditions and provisions of this Agreement.

  1. This Agreement represents the complete understanding between the parties

regarding these issues and no oral representations, statements or inducements have

been made apart from this Agreement. If any provision of this Agreement is held to be

unlawful, void, or for any reason unenforceable, then that provision shall be deemed

severable from this Agreement and shall not affect the validity and enforceability of any

remaining provisions. This Agreement will be interpreted under California law. If I am

signing this Agreement of behalf of a Minor, I hereby further represent, warrant and

guarantee that I have the legal and moral right and authority to bind said Minor to all of

the terms of this Release, Waiver and Covenant and Indemnity as if said Minor were an

adult, and acknowledge that I am giving up substantial legal rights on behalf of the

Minor and that Minor’s parents, legal guardians, heirs, and any other legal or personal

representative. I hereby grant full permission to any and all of the above Released

Parties and Event Organizers to use any photographs, videotapes, motion pictures,

digital images, website images, streaming video or any other record of this Event

without qualification and without compensation.

BY INDICATING YOUR ACCEPTANCE OF THIS AGREEEMENT AND WAIVER, YOU

ARE AFFIRMING THAT YOU HAVE READ AND UNDERSTAND THIS AGREEMENT AND

WAIVER AND FULLY UNDERSTAND ITS TERMS. YOU UNDERSTAND THAT YOU ARE

GIVING UP SUBSTANTIAL RIGHTS, INCLUDING THE RIGHT TO SUE. YOU

ACKNOWLEDGE THAT YOU ARE SIGNING THE AGREEMENT AND WAIVER FREELY

AND VOLUNTARILY, AND INTEND BY YOUR ACCEPTANCE TO BE A COMPLETE AND

UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT

ALLOWED BY LAW.

Uncheck here if you are not agree with above terms.: