Miracle League of Plymouth · Covid 19 Waiver

MLP Participant Information (If under 18 years of age, Parent/Guardian needs to fill out on their behalf)

Name of Participant

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First Name

Last Name

Participant's Email

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Verify Email

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Address

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Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Date of Birth

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(mm/dd/yyyy)

Is the participant 18 years or older?

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Parent/Legal Guardian Name (If participant is under 18 years old)

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First Name

Last Name

Parent/Legal Guardian Email (if participant is under 18 years old)

*

Verify Email

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Mobile Phone

By providing this information you are giving MLP permission to text in case of cancellation or other urgent matters related to volunteering.

Covid- 19 Release

WAIVER/RELEASE FOR COMMUNICABLE DISEASES INCLUDING COVID-19

ASSUMPTION OF RISK / WAIVER OF LIABILITY / INDEMNIFICATION AGREEMENT

In consideration of being allowed to participate in The Miracle League of Plymouth (“MLP”) athletic program, including all related events and activities at The Bilkie Family Field and elsewhere, the undersigned acknowledges and agrees that:

1. The undersigned fully understands and accepts the risks involved in participation in MLP athletic programming.

2. Participation includes possible exposure to, and illness, permanent disability or death from infectious diseases including but not limited to MRSA, influenza, and COVID-19 (“Diseases”); and,

3. I KNOWINGLY AND FREELY ASSUME ALL RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,

4. I willingly agree to comply with the stated and customary terms and conditions for participation with regard to protection against infectious diseases. If, however, I observe and any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,

5. I waive any and all claims against Releasees that I may in the future have arising out of any and all damages/injuries resulting, in part, from my potential exposure to Diseases while participating in this program.

6. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND AGREE TO DEFEND, HOLD HARMLESS AND INDEMNIFY The Miracle League of Plymouth, their officers, officials, agents, and/or employees, volunteers, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“Releasees”), from any lawsuit, claim, or liability whatsoever WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss, expense, or damage of any kind to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

7. If I violate the terms of this Agreement and sue any party otherwise released under this Agreement, that party shall be entitled to recover from me his/her/its expenses, including attorney fees.

8. This Agreement shall be governed and interpreted in accordance with the laws of the State of Michigan. Any litigation involving the parties to this Agreement shall be brought within in the County of Wayne, State of Michigan. This Agreement shall be binding upon me, my heirs, next of kin, executors, administrators, assigns, representatives, and all other parties seeking to claim under or through me, in the event of my death of incapacity.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IF FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

ELECTRONIC SIGNATURE

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

Any Waiver/Release 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 Waiver/Release 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 agrees 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 Waiver/Release on his or her behalf or on behalf of a minor. The electronically signed Waiver/Release, 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 Waiver/Release on the basis that it was not originated or maintained in documentary form.

Name of Participant

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First Name

Last Name

Is the participant 18 years or older?

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Yes

No

FOR PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT THE TIME OF REGISTRATION)

This is to certify that I, as parent/guardian, with legal responsibility for this participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of presence and participation and his/her personal responsibilities for adhering to the rules and regulations for protection against communicable diseases. Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to his/her release provided above for all the Releasees and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees for any and all liabilities incident to my minor child’s/ward’s presence or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent provided by law.

Name of Parent/Guardian

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First Name

Last Name

Name of Child/Ward

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First Name

Last Name

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.

Acknowledgement – I, on my behalf and/or on behalf of my child/ward, acknowledge and agree to the terms and conditions of the Waiver/Release, and further attest that the information provided above is true and correct as of the date this form is signed.

*

Yes

No