4040 Watonga Blvd. Houston, Texas 77092-5399
GLC PICKLEBALL PROGRAM RELEASE AND WAIVER OF
LIABILITY AND INDEMNITY AGREEMENT
| Participant’s Last Name | Participant’s First Name | Participant’s Middle Name | Date of Birth |
|---|
| Street address | City | State | Zip code |
| Home Phone | Work Phone | Cell Phone | |
| Email Address | | | |
| Emergency Contact | Emergency Phone | | |
IN CONSIDERATION of being permitted to participate in GLC Pickleball at Gethsemane Lutheran Church including the training, use of various facilities or equipment and or participation in any way in the various pickleball clinics, pickleball games, conditioning, training sessions, leagues, and all related activities and programs conducted during GLC Pickleball, the PARTICIPANT for himself or herself and any personal representatives, heirs, and next of kin, hereby agrees to the following:
- THE PARTICIPANT HEREBY RELEASES, WAIVES, DISCHARGES AND COVENANTS NOT TO SUE GETHSEMANE LUTHERAN CHURCH, its officers, employees, board and agents (hereinafter referred to as “Released Parties”), from any and all liability to the undersigned, his or her representatives, assigns, heirs and next of kin for any loss or damage, and any claim or demands therefore on account of injury to the person or property or resulting in death of the PARTICIPANT while the undersigned participates in the above pickleball and training activities sponsored, planned, directed and or conducted by GETHSEMANE LUTHERAN CHURCH.
- THE PARTICIPANT HEREBY AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS the Released Parties and each of them from any loss, liability, damage or cost they may incur due to the participation of the PARTICIPANT in the above pickleball and training activities sponsored, planned, directed and or conducted by GETHSEMANE LUTHERAN CHURCH.
- THE PARTICIPANT HEREBY ASSUMES FULL RESPONSIBILITY FOR RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE while participating in the above pickleball and training activities sponsored, planned, directed and or conducted by GETHSEMANE LUTHERAN CHURCH.
(over)
- THE PARTICIPANT IS AWARE THAT PARTICIPATION IN ATHLETIC ACTIVITIES PRESENTS A RISK OF PHYSICAL HARM. The undersigned is aware of the risk that any part of his or her body or any of his or her body systems may be hurt or injured by participating in the above pickleball and training activities.
- THE PARTICIPANT further expressly agrees that the foregoing RELEASE, WAIVER AND INDEMNITY AGREEMENT is intended to be as broad and inclusive as is permitted by the law of the State of Texas and that if any portion thereof is held invalid, it is agreed that the balance shall, continue in full legal force and effect.
- THE PARTICIPANT hereby consents to and gives GETHSEMANE LUTHERAN CHURCH permission and authorization to use and photograph, video recording, audio statements or other media representation of PARTICIPANT'S participation in any GETHSEMANE LUTHERAN CHURCH event or activity in any GETHSEMANE LUTHERAN CHURCH promotional materials, publications, videos and or on the website of GETHSEMANE LUTHERAN CHURCH.
- THE PARTICIPANT HAS READ AND VOLUNTARILY AGREES TO THIS RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT, and further agrees that no oral representations, statements or inducements apart from the foregoing written agreement have been made.
- If my CHILD/PARTICIPANT is a minor (under the age of 18 years) I hereby agree to all of the foregoing terms and provisions on behalf of the minor participant as his/her authorized parent/guardian.
| Signature of Participant (18 years and older must sign) | [___________________________________] |
Participant Name: | ____________________________________ |
Date: | ____________________________________ |
In consideration of _______________ _______________ _______________ (“Minor”) being permitted by Gethsemane Lutheran Church to participate in its activities and to use of any and all its equipment and facilities, I hereby agree to the above PARTICIPANT AGREEMENT, LIABILITY RELEASE, AND ACKNOWLEDGMENT OF RISK on behalf of my minor child, and further agree to indemnify and hold harmless Gethsemane Lutheran Church. from any and all Claims which are brought by, or on behalf of Minor, and which are in any way connected with such use or participation by Minor. |
| Signature of Parent(s) (or Legal Court Appointed Guardian) | [___________________________________] |
Parent/Guardian Name: | _____________________________________ |
Date: |
_____________________________________________ |
