Athlete Enrollment & Waiver

Hampton Harriers · Youth Track & Field

Please read the agreement below, fill out every field, and sign at the bottom.

Program Enrollment, Parental / Guardian Indemnification, Release of Liability, and Assumption of Risk Agreement

Please read this entire document carefully before signing.

1. Parties and Purpose

This Agreement is entered into by the undersigned parent or legal guardian (“Parent/Guardian”) on behalf of themselves and the minor athlete identified below (“Athlete”), in favor of Hampton Harriers, Inc., a youth track and field organization, together with its board of directors, officers, coaches, assistants, volunteers, agents, and representatives (collectively, “Hampton Harriers”). Hampton Harriers conducts and participates in practices, training sessions, conditioning workouts, and competitive track & field and cross-country meets at various indoor and outdoor facilities and locations (collectively, “Program Activities”).

2. Acknowledgment of Inherent Risks

Parent/Guardian acknowledges that participation in track and field and cross-country involves inherent risks that cannot be fully eliminated, including: sprains, strains, fractures, and musculoskeletal injuries; cuts, abrasions, and soft-tissue injuries; overuse and repetitive-motion conditions; heat exhaustion, heat stroke, and dehydration; cardiovascular events including cardiac arrest; collision with other athletes or equipment; concussion and head/brain injuries; and catastrophic injury, permanent disability, or death. Risks may also arise from the negligence of Hampton Harriers, its coaches or volunteers, venue conditions, weather, or equipment.

3. Assumption of Risk

Parent/Guardian, on behalf of themselves and the Athlete, VOLUNTARILY AND KNOWINGLY ASSUMES ALL RISKS associated with the Athlete’s participation in Program Activities, whether or not described herein, including risks arising from the ordinary negligence of Hampton Harriers. Parent/Guardian accepts sole responsibility for the Athlete’s participation and represents that the Athlete is physically capable of participating.

4. Release of Liability

In consideration of the Athlete’s participation, Parent/Guardian, on behalf of themselves, the Athlete, and their respective heirs, executors, administrators, and assigns, hereby RELEASES, WAIVES, DISCHARGES, AND COVENANTS NOT TO SUE Hampton Harriers, Inc. and its board of directors, officers, coaches, assistants, volunteers, agents, and representatives and any venue where practices are held from any and all claims, demands, losses, liabilities, and causes of action of any kind — whether known or unknown, foreseen or unforeseen — arising out of or in connection with the Athlete’s participation in Program Activities, including claims arising from the ordinary negligence of Hampton Harriers, whether occurring during practices, training, travel to/from events, track meets, or any other Program Activity.

5. Indemnification and Hold Harmless

Parent/Guardian agrees to INDEMNIFY, DEFEND, AND HOLD HARMLESS Hampton Harriers, Inc. and its board, officers, coaches, assistants, volunteers, agents, and representatives and any venue where practices are held from and against any and all claims, demands, suits, judgments, losses, costs, and expenses (including reasonable attorneys’ fees) arising out of: (a) any injury, illness, disability, or death suffered by the Athlete during or in connection with Program Activities; (b) any act or omission of the Athlete; (c) any misrepresentation by Parent/Guardian; or (d) any breach of this Agreement.

6. Medical Authorization

If the Athlete requires emergency medical attention and Parent/Guardian cannot be reached in a timely manner, Parent/Guardian authorizes Hampton Harriers coaches or volunteers to consent to emergency medical treatment deemed necessary by qualified medical personnel. Parent/Guardian agrees to be responsible for all resulting medical expenses. Hampton Harriers shall not be liable for medical decisions made in good faith under emergency circumstances.

7. Photo / Media Release & General Provisions

Parent/Guardian grants Hampton Harriers permission to photograph, record, and/or videotape the Athlete during Program Activities for organizational purposes without compensation. If you do NOT consent, check the photo opt-out box below.

This Agreement shall be governed by the laws of the State of New York. If any provision is found unenforceable, the remaining provisions remain in full force. This Agreement constitutes the entire understanding of the parties on its subject matter and is executed voluntarily, without duress.

By signing below, I certify that I have read, understand, and voluntarily agree to all terms of this Agreement and that I am the parent or legal guardian of the Athlete named below.

Athlete Information

Athlete’s First Name*

Athlete’s Last Name*

Date of Birth*

Grade at School*

School Athlete Attends*

Parent / Legal Guardian (Signer)

First Name*

Last Name*

Relationship to Athlete*

Home Address*

City, State, ZIP*

Phone Number*

Email Address*

2nd Parent / Legal Guardian (optional)

First Name

Last Name

Relationship to Athlete

Home Address

City, State, ZIP

Phone Number

Email Address

Emergency Contact

Emergency Contact First Name*

Emergency Contact Last Name*

Phone Number*

Relationship to Athlete*

Alternate Phone

Known Medical Conditions / Allergies / Medications List any medical conditions, allergies, or medications coaches should know about. Write “None” if not applicable.*

Acknowledgments & Signature

Photo / Media OPT-OUT. Check this box only if you do not consent to Hampton Harriers photographing or recording the athlete (per Section 7). Leave unchecked to grant standard permission.

I agree.* I have read and understand the entire agreement above, I am the parent or legal guardian of the named athlete, and my electronic signature below is intended to have the same legal force as a handwritten signature under the U.S. E-SIGN Act and the laws of New York State.

Signature of Parent / Legal Guardian *

Sign here with mouse, finger, or stylus

Date:

On submission, your IP address and a timestamp will be recorded with your signature for legal-record purposes. A copy of the signed waiver will be emailed to the address you provide above.

Register Your Athlete