Description of Risks: I am aware that sports and fitness and similar activities involve inherent risks, dangers and hazards that are associated with unique movement patterns and skills, which may, in some circumstances be executed on specialized apparatus. I acknowledge that personal harm or injury may be sustained during my child or I’s involvement in the activity, including but not limited to broken bones, head injuries, dislocations, tendon and ligament damage, damage to teeth and dental work, spinal injuries that could result in various degrees of paralysis or death. I acknowledge and assume the potential risks and consent to myself and my child’s participation. Consent to Participation: Myself and my child have been informed that we are to abide by the rules and regulations including directions and instructions from the coaches/staff as imposed on myself and my child while participating in the program. In the event that myself and or my child fails to abide by the rules and regulations imposed on myself and/or my child while participating in the program, disciplinary action may either require that myself and he/she not participate in the program or activity. I acknowledge that it is my responsibility to notify the coaches/staff of any physical or mental health concerns for my child which may affect my child’s participation in the program. I acknowledge that the program may require a coach to have direct physical contact with my child designed to assist the participant in the safe performance of the program skills. Waiver of Liability I confirm that I have read the above description of risks and understand the risks involved in participating in the Little Ballers programs. I confirm that I voluntarily and freely accept all such risks, and choose to participate and allow my child to participate in the Little Ballers program and activities. I accept full responsibility for mine and my child’s actions. In consideration of my child being allowed to participate in the Little Ballers program and other activities, I hereby agree as follows: To waive any and all claims that I have or may have in the future against, and to release from any and all liability, the Little Ballers, its owners and coaches/staff, for any and all of the following: personal injury, death, property damage and or loss. Medical/Emergency I further understand and agree that, in the case of an emergency, Little Ballers assumes no responsibility or obligation relative to any cost or expense related to carrying out an emergency procedure and/or emergency transportation for myself and/or my child, and I agree to pay for such costs and expenses and shall indemnify and reimburse the Little Ballers for any such costs or expenses that it incurs.

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