Pro Source Athletics

DISCLAIMER AND WAIVER OF RIGHTS AGREEMENT

 

Name                                                                                              Age                                          DOB                      

Address                                                                                                                                                                           

City                                                                                                 State                                        Zip                         

                        Phone                                                                                                                                    

                        Emergency Contact and Phone                                                                                            

                        Email                                                                                                                                     

 

To the maximum extent permitted by applicable law, in no event shall Pro Source Athletics-Coppell, LLC.  or its suppliers, employees, sponsors, contractors, officers, managers or endorsers be liable for any consequential, incidental, direct, indirect, special, and punitive or other damages whatsoever. In consideration of the opportunity to attend and participate in the Pro Source Athletics-Coppell, LLC. Instruction described as follows: individual or group/team instruction, in addition to all other prior and superseding waiver(s) of their liability, if any, I herby further agree to fully and forever release and discharge Pro Source Athletics-Coppell, LLC. its owner(s), employees, agents and assigns, sponsors and contractors, from any and all claims, demands, rights of action, causes of action, death, bodily injury, present or future, whether known, anticipated or unanticipated, resulting from or arising out of my use or intended use of the facilities or equipment of Pro Source Athletics-Coppell, LLC. Due to negligence or any other fault, including but not limited to any personal injury and I agree that Pro Source Athletics-Coppell, LLC. will not be responsible for loss, damage, or theft of any property whatsoever.  The participant will be liable for payment of all costs incurred by Pro Source Athletics-Coppell, LLC. in the collection of obligations due to Pro Source Athletics-Coppell, LLC. including court costs and reasonable attorney’s fees.  I further acknowledge that I have no adverse health conditions except for                                                                                      (if none, write N/A, not applicable).  I understand I participate in activities on my own accord, agreeing to assume all risks of such exercise and activities, including special activities, and agree to hold harmless Pro Source Athletics-Coppell, LLC.  If the participant is under the age of eighteen(18), I have permission to from my parent/guardian to attend, participate, and additionally fully waive, release and remise any and all liabilities to Pro Source Athletics-Coppell, LLC., their agents, employees, assigns, stockholders, officers and successors in interest.

Parent/Guardian Signature                                                                                              Date                                       

Approved                                                                                                                       Date