ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
While enrolled at Christian Academy School System, students engage in a wide variety of activities, each which may be associated with certain risks.
The undersigned recognizes the dangers and risks to Student that may be associated with his/her participation in the selected sport (hereinafter "Activity".)
The student and parent/legal guardian recognize that participation in interscholastic athletics involves some inherent risks for potentially severe injuries, including but not limited to death, serious neck, head and spinal injuries which may result in complete or partial paralysis, brain damage, serious injury to virtually all internal organs, serious injury to virtually all bones, joints, ligaments, muscles, tendons, and other aspects of the muscular skeletal system, and serious injury or impairment to other aspects of the body, or effects to the general health and well-being of the child. Because of these inherent risks, the student and parent/legal guardian recognize the importance of the student obeying the coaches' instructions regarding playing techniques, training and other team rules. By signing this form, the student and parent/legal guardian acknowledge that the student's participation is wholly voluntary and to having read and understood this provision.
The undersigned understands that this Activity, including travel to and from this activity, involves certain risks for physical injury and further understands that there are potential risks of which the undersigned may not presently be aware.
The undersigned assumes all foreseeable and unforeseeable risks associated with travel to, from and within the Activity and releases Christian Academy School System and its agents from any responsibility for such risks. The undersigned acknowledges that carriers, hotels and other suppliers providing services in connection with the Activity (herein after referred to as "suppliers") are independent contractors and are not agents, employees or representatives of, or joint venturers with, Christian Academy School System and release Christian Academy School System from any responsibility for the actions or omissions of such suppliers. The undersigned accepts full responsibility for luggage and other belongings brought by Student on the trip and acknowledge that Christian Academy School System is not responsible for such items.
The undersigned represents that the Parent(s) identified below are the parents, legal custodians or legal guardians of the Student, if the Student is a minor. The undersigned affirms that he or she is mindful of the risks of injury and/or property loss associated with the Activity, and the undersigned assumes full risk and responsibility for any accidents or injuries to the Student. The undersigned represents and warrants that the Student has no physical or mental condition which creates an unusual or undue risk of accident or injury while engaged in event activities.
In consideration for facilitating Student's participation in the Activity, the undersigned agrees to indemnify and hold harmless Christian Academy School System and any of its officers, directors, agents, servants, affiliates, and employees for any claim of personal injury, property damage, or other losses arising out of or in any way related to Student's presence at and/or participation in the Activity (including travel to and from the Activity), whether caused by negligence Christian Academy School System, its employees, officers, directors, agents, servants, affiliates, or other persons or entities conducting or sponsoring the Activity, or otherwise. The undersigned further agrees that should there be any injury or illness to the Student, Student's health insurance shall be the carrier primarily responsible for Student's medical expenses.
In the event of a perceived medical emergency, the undersigned hereby grants permission for Christian Academy School System to obtain necessary medical treatment in case of sickness or injury to Student. Medical treatment means any medical, chiropractic, optometric, or dental examination, diagnostic procedure, and treatment, including but not limited to hospitalization, radiology services, pharmacy services, and blood testing. This authorization is intended to, and does hereby, grant to Christian Academy School System full power and authority to do and perform each and every act and thing whatsoever requisite, necessary and proper to be done as we might or could do if personally present, hereby ratifying and confirming all that Christian Academy School System shall do or cause to be done by virtue of the authority granted hereby.
The undersigned agrees and understands that if any provision hereof is held to be invalid for any reason whatsoever, the remaining provisions shall not be affected thereby. If such provision may be modified or reformed so as to be valid, then the provision shall be deemed to be so modified or reformed so as to be enforceable. This contract shall be interpreted according to Kentucky law.
By submitting this form I agree to all terms and conditions specified herein.