EMERGENCY MEDICAL & LIABILITY RELEASE FORM
In consideration for my child being permitted to participate in the Elite Racing as set forth above, I release and hold harmless Elite Racing, its agents, employers, employees, members, independent contractors, and any of its affiliates from any and all liability for injury to my child ________________or to property resulting from the negligence or other acts, howsoever caused, by any agent, employer, employee, member, or independent contractor of Elite Racing, or its affiliates, as a result of my child’s participation in the Elite Racing. I further agree that I, my assignees, and legal representatives will not make a claim against, sue, or attach the property of Elite Racing, or its agents, employers, employees, members, independent contractors, and any of its affiliates, arising out of any such injury.
I understand that this program will involve motion, height and various physical challenges, and I hereby agree that _______________ (child’s name) may participate in such activities that could result in injury. I acknowledge that I have discussed with my physician the appropriateness of this program in connection with any illness or condition that my child may now have or previously had, and that I knowingly execute this release from liability and negligence.
I HAVE CAREFULLY READ THIS RELEASE FORM AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND IS A CONTRACT BETWEEN MYSELF AS PARENT AND GUARDIAN OF MY CHILD AND ELITE RACING AND ITS AFFILIATES, AND SIGN IT OF MY OWN FREE WILL.
In the event of an accident or illness, and the parent or emergency contact person, (as shown in this application) cannot be reached, I give Elite Racing and its authorized affiliates permission to consent on my behalf to medical care for my child, ____________________________. With my signature, I acknowledge that I agree to the Medical Release statement as described.
POLICIES & PROCEDURES
Payment Terms: By signing below I verify that I understand the payment terms and understand that fees outlined below will apply should I decide or need to cancel or reschedule.
1) All participants must be dropped off and picked up at designated location for each practice.
2) All payment must be received prior to start of season.
3) There will be a $1 per minute fee, if late in picking up your child after session.
4) I understand that any missed days will NOT be refunded or credited.
5) I understand that any rescheduling is at the discretion of the director.
6) If disciplinary action is necessary and child is asked to leave practice, there will be no refund of payment for that session.
PUBLICATION/IMAGE/VIDEO RELEASE AGREEMENT
Parents/Guardians may give permission to allow their child (children) to participate in the following:
Approval for the participants name, picture, voice, verbal statements or portraits (video or still) to appear in Elite Racing publications, social media and website. For example, pictures and articles about Elite Racing activities may appear in newsletters, social media sites, videos, local newspapers, and local television coverage. These pictures and articles may or may not personally identify the student. Photos of students will appear on the Elite Racing website, however, first name only will appear on the website and in any advertising. Elite Racing may use the participant’s name, pictures, voice, verbal statements or portraits (video or still) in subsequent years. No monetary consideration shall be paid. I understand and give permission for my child (children) to participate.