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ETERNITY PARTICIPANT WAIVER (updated 2021)
Information regarding participant (if participant is under 18, then enter parent/guardian information in this section and participants information in family section below:
If the participant is under the age of 18, then the form must be submitted by a guardian or parent
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First Name
Last Name
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(mm/dd/yyyy)
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code

By providing this information you are giving MLP permission to text in case of cancellation or other urgent matters related to participating.
Family Section
If you have multiple children volunteering you may use one form for all of your children.

First Name
Last Name

(mm/dd/yyyy)

First Name
Last Name

(mm/dd/yyyy)

First Name
Last Name

RELEASE AND WAIVER
(Revised February 24, 2021)

This Release and Waiver applies to any adult participating in the Activities (as defined below) as well as to any adult who wishes to allow his or her minor child to participate in the Activities.

Specifically, the undersigned, on his or her behalf or on behalf of his or her minor child, desires to volunteer to assist in, and/or to allow his or her child (the “Minor”) to participate in officially sanctioned baseball games and related activities played at The Bilkie Family Field and elsewhere, including practice sessions, pre-game and post-game activities, as well as all other officially sanctioned activities of The Miracle League of Plymouth (the “Organization”) that take place at The Bilkie Family Field and elsewhere, including, but not limited to, the annual Easter Egg Hunt, Family Picnic, 4th of July Parade, Holiday Party and Trick or Treating (the “Activities”) sponsored by The Miracle League, a Michigan not-for-profit corporation.

DISCLOSURE OF RISK

The undersigned is aware that normal and usual athletic and sports related activities have certain inherent risks for participants, including, by way of example and without limitation, athletes, officiants, and coaches, and the inherent risks may cause injury to participants and volunteers, including of any the undersigned and/or the Minor.

Risks associated with said participation in the Activities include the risk of serious injury, illness, or death. Risks may result from the undersigned’s or Minor’s actions, inaction, or negligence and also from the actions, inaction, or negligence of other individuals (adults and other minors), the condition of the facilities or area where the activity is being conducted, weather conditions, playing conditions, equipment, other participants, and the rules of performance or play for the activity. The very nature of the Activities is hazardous and risky, including, but not limited to, the acts of pitching, throwing, fielding and catching of the ball, the swinging of the bat, running, jumping, stretching, sliding, diving, and collisions with other participants and with stationary objects, all of which can cause serious injury or death.

ACKNOWLEDGEMENT OF RISK

The undersigned understands the risks of participation in the activities as it relates to the undersigned and/or the Minor. Further, the undersigned will completely and fully discuss any concerns regarding these risks with staff prior to signing this Release and Waiver, and prior to Minor’s participation in any Activities.

ASSUMPTION OF RISK AND RESPONSIBILITY

With full knowledge and understanding of the risks involved relating to participation in the Activities, the undersigned, on his or her behalf and on behalf the Minor, hereby voluntarily and willingly assumes full and complete responsibility for all losses and damages, including injury, illness, and death, resulting from the undersigned and/or Minor’s participation in the Activity, including transportation to and from the Activity. The undersigned agrees that he or she shall be solely responsible for any losses and damages resulting from participation in the Activity by the undersigned and/or the Minor.

Further, the undersigned consents to first-aid and/or emergency care by qualified Emergency Medical Technician or physician or other person qualified to render medical assistance to the undersigned or Minor in the event either suffers an injury during any of the Activities.

INDEMNIFICATION

The undersigned, on his or her behalf and on behalf of the Minor, hereby agrees to indemnify, release, hold harmless and forever discharge the Organization and its agents, employees, officers, directors, volunteers, affiliates, successors and assigns, of and from any and all claims, demands, debts, contracts, expenses, causes of action, lawsuits, damages or liabilities, of any kind or nature, whether known or unknown, in law or in equity, that the undersigned or the Minor ever had or may have, arising from or in any way related to the undersigned or minor’s participation in any Activities conducted by, on the premises of, for the benefit of, or in any way relating to the Organization; provided, that this Release and Waiver does not apply to any acts of gross negligence or intentional, willful or wanton misconduct.

In the event that any claim is threatened or made on the Minor’s behalf by a third-party challenging the enforceability of this Release and Waiver, the undersigned further agrees to indemnify and hold harmless the Organization and its agents, employees, officers, directors, volunteers, affiliates, successors and assigns, from any and all such claims, demands, debts, contracts, expenses, causes of action, lawsuits, damages or liabilities, of any kind or nature, whether known or unknown, in law or in equity, arising from or relating to said claims.

Media and Photography

The undersigned, on his or her behalf and on behalf of the Minor, understands that there will be media and promotional coverage of the Activities and hereby grants permission to the Organization and its affiliates, franchises, advertising and promotional agencies, and their agents, the irrevocable, unrestricted right to use, publish, display and distribute materials bearing the name, voice, likeness or any other identifiable representation of the undersigned or the Minor, for lawful use in publications (such as brochures, newsletters, and magazines), promotions, broadcasts, advertisements, posters, and to use the photographs on display boards, and to use such photographs in electronic versions of the same publications or on the Organization’s web sites or other electronic form or media, and to offer them for lawful use or distribution in other non-company publications, electronic or otherwise, without notifying the undersigned.

All material containing identifiable representation of the undersigned or Minor (including without limitation, all negatives, plates, and masters of any photographs, files prints or tapes) shall be and remain the sole and exclusive property of the Organization.

The undersigned, on the undersigned’s behalf and on behalf of the Minor, hereby releases and forever discharges the Organization from any and all liability and damages relating to the use of the undersigned’s or the Minor’s name, voice, likeness or any identifiable representation of the undersigned or the Minor, and waives any right the undersigned may have to inspect or approve the finished materials or any part or element thereof that incorporates the name, voice, likeness or any other identifiable representation of the undersigned or the Minor.

The undersigned, on his or her behalf and on behalf of the Minor, has agreed to the above in consideration of the opportunity to appear in these materials.

ADULT VOLUNTEERS – RECORDS SEARCH

To the extent the undersigned shall be allowed to serve as a volunteer for the Organization and/or the Activities, the undersigned hereby gives full consent and permission to the Organization to obtain information relating to the undersigned’s criminal history and any other applicable records through a third party and their agents. The records as received by the reporting agencies may include, but not limited to, arrest, conviction, social security verification and/or driving records as well as plea bargains, deferred adjudications, and delinquent conduct committed as a juvenile.

The undersigned agrees and acknowledges that this information will be used in part to determine his or her eligibility to participate in Activities and that as long as the undersigned serves as a volunteer, the Organization my update said records at any time. The undersigned hereby remises, releases, and forever discharges and agrees to indemnify the Organization and any provider of the background screening, including their respective officers, directors, employees, volunteers and agents, and to hold them harmless from and against any and all causes and actions, including but not limited to suits, liabilities, costs, debts, and sums of money, claims, and demands whatsoever (including claims for negligence, gross negligence, and/or strict liability) and any and all related attorney fees, court costs, and other expenses resulting from said background investigation.

Further, the undersigned acknowledges and agrees that:

  • The Organization may deny participation to any person who has been convicted of a serious crime, and
  • That any inappropriate and/or unacceptable conversation or conduct with a minor may be grounds for immediate dismissal.

This Release and Waiver shall remain valid and in effect unless and until notification is made in writing to the Miracle League of Plymouth at 525 Farmer Street, Plymouth, MI 48170 to cancel said waiver. At a minimum, this waiver may be retained for up to 6 years.

The undersigned represents and warrants that he or she is of lawful age and legally competent to sign this document, I understand the terms herein, and I have signed this document as my own free act and deed.

Electronic Signature

This Release and Waiver may be executed as a hard copy document or by electric signature through a website hosting the Agreement.

Any Release and Waiver executed by means of a “click” on the designated space or similar means shall be considered to be a “writing” or “in writing” and any such Release and Waiver shall be deemed for all purposes: (i) to have been “signed”, and (ii) to constitute an “original” when printed from electronic files or records established and maintained in the normal course of business. The undersigned agree not to contest the validity or enforceability of such electronic signatures under the provision of any applicable law relating to the authority of the undersigned to execute this Release and Waiver on his or her behalf or on behalf of a Minor. The electronically signed Release and Waiver, if introduced as evidence in any judicial, arbitration, mediation or administrative proceeding, will be admissible as to the same extent and under the same conditions as other business records originated and maintained in paper documentary forms. The undersigned agrees that he or she shall not contest the admissibility of signed Release and waiver on the basis that it was not originated or maintained in documentary form.


(mm/dd/yyyy)

Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code

For all volunteers over 18 please answer the following questions:

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Have you been charged or convicted of an offense involving harm or threat of harm against a person or persons?
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Have you been charged or convicted of an offense involving sexual offenses (including pornography and “victimless” crimes)?
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Have you been charged or convicted of an offense involving drugs and/or other controlled substances within the last 10 years?
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Have you been charged or convicted of an offense involving cruelty to animals?
CERTIFICATION STATEMENT
I certify that the above statements are true and that the making of false statements may be considered sufficient cause for immediate dismissal upon discovery thereof. I understand, and agree, that any misleading information or omission of information may be cause for dismissal.
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