Adaptive Sports Centers (SASC)

2025 Waiver

Please, only sign this waiver once per calendar year.

Thank you!

Who are you signing for?

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Myself

Someone Under 18 or Legally Incapacitated

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!! You Are Signing for Yourself !!

!! You Signing for Someone Under 18 or Legally Incapacitated !!

I am a

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Participant with a Disability

SASC Volunteer

Able-Bodied Companion

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In consideration of being allowed to participate in any way in SPAULDING programs, related events, and activities, I and/or the minor participant, for myself, and on behalf of my heirs, assigns, personal representatives and next of kin, the undersigned:

1. Agree that prior to participating, I will inspect, or if a parent and/or legal guardian I will instruct the minor participant to inspect, the facilities and equipment to be used, and if I believe, to the best of my ability, that anything is unsafe, I and/or the minor participant will immediately advise SPAULDING of such condition(s)and refuse to participate.

2. Acknowledge and fully understand that I and/or the minor participant, will be engaging in activities that involve risk of serious injury, including permanent disability and death, and severe social and economic losses which might result only from my own actions, inactions or negligence of others, the rules of play, or the condition of the premises or any equipment used. Further, that there may be other risks not known to me or not reasonably foreseeable at this time.

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

4. Release, waive, discharge and covenant not to sue SPAULDING, its affiliated clubs, their representative administrators, directors, agents, coaches, and other employees of the organization, other participants, sponsoring agencies, sponsors, advertisers, their heirs, and if applicable, owners and leasers of premises used to conduct the event, all of which are hereinafter referred to as "releases", from 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 of the release or otherwise.

5. By signing this waiver, I give Spaulding Adaptive Sports Centers and the Kelley Adaptive Sports Research Institute permission to use my de-identified data for research purposes.

I / WE HAVE READ THE ABOVE WAIVER AND RELEASE, UNDERSTAND THAT I / WE HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, HAVE NOT CHANGED IT ORALLY, AND SIGN IT VOLUNTARILY.

Participant Full Name

First

Middle Initial

Last

Participant's Date of Birth

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M-D-Y

Please Sign for Consent
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FOR PARTICIPANTS OF MINORITY AGE or that have a LEGAL GUARDIAN
This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child's involvement or participation in these programs as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE.

Signee Information

Full Name

Emergency Phone

Relationship to Participant

I am voluntarily choosing to participate in these activities with full recognition and appreciation of the dangers, risks and hazards involved.

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Yes

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Parent/Guardian Signature:
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I hereby authorize and give my full consent to SPAULDING to copyright and/or publish any and all photographs, videotapes and/or film in which I and/or the participant appear while attending this SPAULDING event. I further agree that SPAULDING may transfer, use or cause to be used, these photographs, videotapes, or films for any exhibitions, public displays, publications, commercials, art and advertising purposes, and television programs without limitations or reservations.

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Yes

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Please sign below:
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Click 'Confirmation' below

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