Registration and Release and Assumption of Risk Form

Event Details:

Date: Saturday, July 15, 2023
Time: 9:30-11:30am
Nippert Stadium: 2700 Bearcat Way, Cincinnati, OH 45221
Ages: 4-14

Parent Full Name: *

First NameLast Name

Parent Address: *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent Contact Phone Number: *

Please enter a valid phone number.

Parent Email:*

example@example.com

School District you live in:*

How many attendees are you registering for including yourself?*

RELEASE AND ASSUMPTION OF RISK

I understand that I am signing this release as a condition to and in consideration of my participation in the Recess in the Stadium on July 15, 2023 [SG1] that involves one or more non-contact skill course activities and/or interactive games (collectively “the event”).

I understand that, among other risks, there may be risks of injury to person and property while participating in the event, including, but not limited to, severely strained, torn and pulled muscles; severely strained, torn, pulled and ruptured ligaments and tendons; cartilage damage; broken bones; contusions; and injuries to the head, elbow, back, spinal cord, knee, foot and ankle. I am also aware of the highly contagious nature of bacterial and viral diseases including the 2019 novel coronavirus disease (COVID-19), influenza and other infectious diseases (collectively, the “disease”) and the risk that I may be exposed to or contract the disease by engaging in the event, which may result in serious illness, personal injury, disability, and/or death.

I represent and warrant I am in good physical condition and that I have no medical condition which prevents me from participating in the event. I understand that any injury or disease which I may sustain or contract during the event may reduce or eliminate my ability to participate in other life functions. I understand and agree that I will be responsible for my care and treatment in the event I sustain an injury or contact a disease during or as a result of my participation in the event.

Therefore, for good and valuable consideration, receipt of which is hereby acknowledged, I fully and forever release and discharge The University of Cincinnati, Board of Commissioners of Hamilton County, Nippert Stadium, American Heart Association, Inc. and Cincinnati Children’s Hospital Medical Center and their representative agents, officers, employees or volunteers, all participating sponsors and their respective partners, members, shareholders, officers, directors and employees, parent and subsidiary corporations, any business entities in which they may have any ownership or management interest, and all persons acting by, through, under or in concert with them, or of any them (hereinafter individually and collectively referred to as “Released Parties”), from any and all liability or claims of any nature and of every kind whatsoever, known or unknown, suspected, fixed or contingent, including, without limitation, liability from the negligence of the Released Parties, that I may have now or in the future, or that any person claiming through me may have or claims to have now or in the future, in connection with or resulting from my participation in any of the physical activities.

I hereby agree to indemnify and hold harmless the Released Parties and each of them from and against any and all liabilities, claims, suits, actions, damages, costs and expenses (including attorney’s fees) due to any personal injury, or damage to property caused by me, members of my household or family, the agents employees, contractors, visitors, and guests of any of us, which injury or damage may arise in connection with the physical activities, whether such injury or damage is caused by the active or passive negligence of Released Parties or otherwise.

This signed statement shall serve as a release and assumption of risk for me, my heirs, executors, and assigns.

I grant The University of Cincinnati, Board of Commissioners of Hamilton County, Nippert Stadium, American Heart Association, Inc. and Cincinnati Children’s Hospital Medical Center the right to use my name, likeness, portrait, recorded voice and biographical material in order to advertise, promote and publicize The University of Cincinnati, Board of Commissioners of Hamilton County, Nippert Stadium, American Heart Association, Inc. and Cincinnati Children’s Hospital Medical Center, but not, as an endorsement of any product or service of any advertiser.

This Release and Assumption of Risk shall be governed by the laws of Ohio without regard to its conflicts of laws and provisions. The invalidity or unenforceability of any provisions of this Release and Assumption of Risk shall not affect the validity or enforceability of any other provisions of this Release and Assumption of Risk. In the event that any provisions of this Release and Assumption of Risk is determined to be invalid or unenforceable, such provision shall be deemed restated to be as broad and inclusive as permitted by law, and the remainder of the Release and Assumption of Risk shall remain in full force and effect.

Participant /Attendee Printed Name 1: *

First NameLast Name

Age 1:*

Phone Number 1:

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Participant /Attendee Signature 1:*

Today’s date 1:*

Date

Participant /Attendee Printed Name 2: *

First NameLast Name

Age 2:*

Phone Number 2:

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Participant /Attendee Signature 2:*

Today’s date 2:*

Date

Participant /Attendee Printed Name 3: *

First NameLast Name

Age 3:*

Phone Number 3:

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Participant /Attendee Signature 3:*

Today’s date 3:*

Date

Participant /Attendee Printed Name 4: *

First NameLast Name

Age 4:*

Phone Number 4:

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Participant /Attendee Signature 4:*

Today’s date 4:*

Date

Participant /Attendee Printed Name 5: *

First NameLast Name

Age 5:*

Phone Number 5:

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Participant /Attendee Signature 5:*

Today’s date 5:*

Date

Participant /Attendee Printed Name 6: *

First NameLast Name

Age 6:*

Phone Number 6:

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Participant /Attendee Signature 6:*

Today’s date 6:*

Date

Participant /Attendee Printed Name 7: *

First NameLast Name

Age 7:*

Phone Number 7:

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Participant /Attendee Signature 7:*

Today’s date 7:*

Date

Participant /Attendee Printed Name 8: *

First NameLast Name

Age 8:*

Phone Number 8:

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Participant /Attendee Signature 8:*

Today’s date 8:*

Date

Participant /Attendee Printed Name 9: *

First NameLast Name

Age 9:*

Phone Number 9:

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Participant /Attendee Signature 9:*

Today’s date 9:*

Date

Participant /Attendee Printed Name 10: *

First NameLast Name

Age 10:*

Phone Number 10:

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Participant /Attendee Signature 10:*

Today’s date 10:*

Date

PARENTAL CONSENT (If under 18 years old, participant must have parent or legal guardian’s consent)

I, the minor’s parent and/or legal guardian, understand the nature of the above referenced activities and the Minor’s experience and capabilities and believe that minor to be qualified to participate in the Event. I hereby release, discharge, covenant not to sue and AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS each of the Released Parties from all liability, claims, demands, losses or damages on the minor’s account caused or alleged to have been caused in whole or in part by the negligence of the Released Parties or otherwise, including negligent rescue operations, and further agree that if, despite this release, I, the minor, or anyone on the minor’s behalf makes a claim against any of the above Released Parties, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS each of the Released Parties from any litigation expenses, attorney fees, loss liability, damage, or cost any Released Parties may incur as a result of any such claim. I grant The University of Cincinnati, Board of Commissioners of Hamilton County, Nippert Stadium, American Heart Association, Inc. and Cincinnati Children’s Hospital Medical Center the right to use the Minor’s name, likeness, portrait, recorded voice and biographical material in order to advertise, promote and publicize The University of Cincinnati, Board of Commissioners of Hamilton County, Nippert Stadium, American Heart Association, Inc. and Cincinnati Children’s Hospital Medical Center, but not, as an endorsement of any product or service of any advertiser.

Printed Name of Parent/Legal Guardian: *

First NameLast Name

Phone Number:*

Please enter a valid phone number.

Signature*

Today’s date:*

Date