In Consideration of Being Allowed to Participate in Any Way, in Any Hickory Christian

WaiverForm

In consideration of being allowed to participate in any way, in any Hickory Christian Academysportsprograms, events or activities, I understand, acknowledge and agree to thefollowing:

1.I certify that I am physically fit and able to participate in the program, event or activity, and havenotbeen advised otherwise by a qualified medicalprofessional.

2.I agree to comply with any and all rules, regulations, terms and conditions for participation intheprogram, event oractivity.

3.I acknowledge and fully understand that as a participant, I will be engaging in activities thatinvolverisk of serious injury, including permanent disability and death, property loss and severe socialandeconomic losses. These risks include, but are not limited to, those caused by: (a) the actions,inactionsor negligence of Hickory Christian Academy, participants, volunteers, spectators, coaches,eventofficials, referees and organizers; (b) conditions of the premises or equipment used; (c) rules ofplay;

(d) temperature; (e) weather; (f) condition of participants; and, (g) vehicular traffic. Ifurtheracknowledge and fully understand that there may also be other risks that are not known orforeseeableat this time. I KNOWINGLY AND VOLUNTARILY ASSUME ALL SUCH RISKS, EVENIFARISING FROM THE NEGLIGENCE OF HICKORY CHRISTIAN ACADEMY OROTHERS,AND I ASSUME FULL RESPONSIBILITY AND LIABILITY FOR MYPARTICIPATION.

4.I, on behalf of myself and children, hereby waive, release, discharge, and agree not to sueHickoryChristian Academy, its managers, members, directors, officers, employees, volunteers,representatives,agents, coaches and referees, and other participants, sponsoring agencies, sponsors, advertisers andifapplicable, owners and leasers of equipment and premises used to conduct the programs, eventsoractivities (collectively the “Releases”), from any and all claims for damages, injuries, losses,liabilitiesand expenses which I may have or which may subsequently accrue to me, relating to, resulting fromorarising out of my use and/or participation in any programs, events or activities of HickoryChristianAcademy, including any injury or damage to my person or property, or to that of any other personorproperty.

5.I agree to indemnify, defend and hold the Releases harmless from and against any and all claimsfordamages, injuries, losses, liabilities and expenses relating to, resulting from or arising out ofmyparticipation in any Hickory Christian Academy program, event oractivity.

6.I consent to have medical treatment that may be deemed advisable in the event of injury,accidentand/or illness during any program, event or activity. I release Hickory Christian Academy andallpersons participating in any such medical treatment from all responsibility for any suchactions.

7.I intend that this Waiver and Release of Liability shall be construed broadly to provide a releaseandwaiver to the maximum extent permissible under applicablelaw.

BY SIGNING, I ACKNOWLEDGE THAT I HAVE READ THIS WAIVER AND RELEASEOFLIABILITY AND I FULLY UNDERSTAND ITS TERMS, AND I UNDERSTAND THAT IHAVEGIVEN UP SUBSTANTIAL RIGHTS, AND I SIGN IT KNOWINGLY ANDVOLUNTARILYWITHOUT ANY INDUCEMENT ORDURESS.

Student/Athlete(Print)Student/Athlete(Signature) Parent/Guardian(Print) Parent/Guardian(Signature)