Tryouts - COVID 19 & Health Waiver
PLEASE READ BEFORE SIGNING - you will be able to provide the mandatory signature at the end of the
online form on the previous page.
In consideration of being allowed to participate in any way in the Southside Swarm VBC, Inc. program, whether
involving team or individual sports and related events and activities, the undersigned acknowledges, appreciates, and
1. The risk of injury and/or illness from the activities involved in the program is significant, including the potential for
permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce the risk, the
risk of serious injury does exist;
2. The risk to have direct or indirect contact with individuals who have been exposed to and/or diagnosed with one
or more communicable diseases, including but not limited to COVID-19 or other medical conditions, diseases, or
maladies, and/or any mutation or variation thereof does exist and it is impossible to eliminate the risk that I could become
infected through contact with or close proximity to an individual with a communicable disease;
3. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM
THE NEGLIGENCE OF THE RELEASES 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. If, however, I
observe any unusual, significant hazard during my presence or participation, I will remove myself from participation and
bring such hazard to the attention of the nearest official immediately; and,
5. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE
AND HOLD HARMLESS Southside Sqwarm VBC, Inc, its officers, officials, agents and/or employees, other participants,
sponsoring agencies, directors, sponsors, advertisers, and, if applicable, owners and lessors of the premises, including
Holy Spirit Catholic Church, used to conduct the event (collectively, the "Releases"), WITH RESPECT TO ANY AND
ALL INJURY, ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM
THE NEGLIGENCE OF THE RELEASES OR OTHERWISE.
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 IT
FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
FOR PARENT/GUARDIAN OF PARTICIPANT OF MINORITY AGE: This is to certify that I, as parent/legal guardian
with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the
Releases, and, for myself, my heirs, assigns and next of kin, I release and agree to indemnify the Releases from any and
all liabilities incident to my minor child's involvement or participation in these programs as provided above, EVEN IF
ARISING FROM THEIR NEGLIGENCE.
By signing up for this tryout, training session , camp or league, I, as the parent or legal guardian, agrees to the above
statements. I agree that typing in my name in the space provided on the previous page acts as my legal signature.