USA INLINE MEMBER #__________________________________
SCHOOL NAME:­­­­­­­­­­­­­­­­­­­_________________________________________

PLAYER NAME:­­­­­­­­­­­­­­­­­­­­­­_________________________________________
BIRTHDATE:____________________________AGE:___________
STREET ADDRESS:______________________________________
CITY:__________________________________ZIP:_____________
PHONE:________________________CELL___________________
EMAIL:_________________________________________________

PARENTS NAME:________________________________________

PARENT/GAURDIAN SIGNATURE_________________________
I/We have read the waiver and release of liability listed below, and understand that we have given up substantial rights by signing it and sign it voluntarily.

Amateur Athletic Player and Minor Waiver and Release of Liability
If consideration of being allowed to participant in any way in the
Scotts Valley Sports Center Sports program and related events and activities.

1. Agree that the parent (s) and/or legal guardian (s) will instruct the minor participant, that prior to participating, he or she should inspect the facilities and equipment to be used, and if the participant believes anything is unsafe, he or she should immediately advise his or her coach or supervisor of such condition(s).

2. Acknowledge and fully understand that each participant will be engaging in activities that involve risk of serious injury, including permanent disability and death, and sever social and economic losses which might result not only from their own actions, inactions or negligence, but the action, inaction or negligence of others, the rules of play, or the condition of the premises or of equipment used. Further, that there may be risks not known to us or not reasonably foreseeable at this time.

3. Assume all the foregoing risk and accept personal responsibility for the damages following such injury, permanent disability or death.

4. Release, waiver, discharge and covenant not to sue Scotts Valley Sports Center, it's affiliated organizations, their administrators,

directors, agents, coaches and other employees of the organization, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and leasers of premises used to conduct the event, all of which are hereinafter referred to as “releases”, from any and all liability to each of the under signed, his or her heirs and next of kin for any and all claims, demands, losses or damages on account of injury, including death or damage to property, caused or alleged to be caused in whole or in part by the negligence or releases or otherwise.

5. Players will allow photos, images and name to be used for advertising, promotions and on our website.