EPIC Sports and Recreation Consent/Waiver

By signing/submitting the registration form, you agree to assume the risk of injury if you or your child (adult or minor) participates in league play and agree to give up your right to make any claims for money damages against the East Plano Islamic Center (EPIC).

  • I, the undersigned, as the undersigned or as the parent or legal guardian of the minor child (“my child”) named below, do hereby give my full consent and approval for me or my child to participate as a member of East Plano Islamic Center’s (EPIC’s) Recreation Programs.
  • I understand that there are certain risks of damages and injuries inherent in the Recreation Programs, as well as in traveling and in other related activities incidental to my or my minor child’s participation, and I am willing to assume these risks on behalf of myself or my child. These risks include, but are not limited to, those hazards associated with weather conditions, travel, playing conditions, equipment and other participants.
  • I understand that there is inherent risk in Recreation Programs and that inherent risk means those dangers or conditions, known or unknown, which are characteristic of, intrinsic to, or an integral part of the activity; and that the term “inherent risk” further includes, but is not limited to:
    (1) the failure by the Released Parties to warn me or my child of an inherent risk, and
    (2) the risk that someone may act in a negligent or intentional manner and contribute to the injury of me or my minor child.
  • Further, I agree that in consideration for my or my child’s participation in EPIC’s Recreation Programs, I hereby waive, release, discharge and agree not to sue EPIC, its committees, employees, officials, coaches, volunteers and agents (“Released Parties”), for any and all causes of actions, claims or damages arising out of or resulting from my or my child’s participation in this activity, including but not limited to damages and injuries arising out of the negligence of Released Parties or otherwise. I agree that for me or my child to participate in the activity, I assume full responsibility for any loss of property, accident, and bodily injury as a result of my or my child’s participation in this activity.
  • I hereby permit EPIC to use or distribute any or all still and/or moving images in which I/my child/my ward appear for any use including, but not limited to: video, Web, print and multimedia applications; training or other instructional materials; advertising, commercials or other promotional materials; and other forms of media, without compensation. Any image (s) created shall be the property of EPIC. 
  • I hereby give permission for me or my child/ward to receive necessary medical treatment.
  • I further agree on behalf of myself and my child listed below, that I shall hold harmless and fully indemnify and defend the Released Parties from any and all causes of action, claims, damages, costs including but not limited to attorney’s fees and costs, which may arise from any cause of action made by me or by, through or on behalf of me or my child, even if the damages, injuries are caused in whole or in part by the negligence of the Released Parties.

I acknowledge (a) that I have read (or have had read to me) each and every one of the provisions in this waiver, release of liability and indemnification agreement, (b) that I understand each of the provisions in this agreement and (c) that I agree to abide by them.

PRINT NAME OF MINOR CHILD     ________________________________

ADDRESS     ________________________________________________________

PRINT NAME OF NATURAL GUARDIAN OR ADULT PARTICIPANT ________________________________________________________

SIGNATURE OF NATURAL GUARDIAN OR ADULT PARTICIPANT  ________________________________________________________

DATE: _________________________