Loudoun Youth Football Experience, LLC

Loudoun Youth Football Experience, LLC

PARENT/GUARDIAN-PARTICIPANT RELEASE AND INFORMED CONSENT AGREEMENT

Completion of this Participant Release and Informed Consent Agreement (the “Agreement”) is required for participation in Loudoun Youth Football Experience, LLC. (LYFE, LLC)

By signing this Agreement, I/We grant permission for ______(athlete’s name) My signature also acknowledges my review of and consent to all of the terms and conditions contained in this Agreement.

Section 1 – Contact Information

Parent/Guardian’s Name: ______

Home Address: ______

Home Phone: ______Cell Phone: ______

Section 2 – Release & Consent

For the consideration of the Athlete’s participation in the session, I irrevocably and expressly release, forever discharge, agree not to sue, and warrant to indemnify and hold harmless LYFE, LLC and LYFE, LLC directors, officers, employees, agents, shareholders, partners, volunteers, representatives, assigns, and insurers (collectively, “LYFE, LLC Parties”) from and against any liabilities, claims, demands and causes of action on account of any loss, damage, illness and/or injury to the athlete’s person or property arising out of or relating to participation in any aspect of the training.

I also agree to indemnify and hold harmless LYFE, LLC Parties from and against any liabilities, claims, demands and causes of action by my or the athlete’s heirs, personal representatives, or assigns arising out of or relating to the athlete’s participation in the training.

I further agree to indemnify and hold harmless LYFE, LLC Parties from and against any liabilities, claims, demands and causes of action by third parties, including but not limited to by-standers and other session participants, arising out of or relating to the athlete’s actions and/or inactions. In no event shall LYFE LLC Parties be liable for consequential, exemplary, extraordinary, incidental, indirect, special or punitive damages or for any damages whatsoever arising out of or relating to the athlete’s participation.

I additionally acknowledge that should the athlete fail to abide by the rules prescribed by LYFE, LLC Parties while participating in the session, LYFE, LLC may, in its sole discretion, terminate the athlete’s participation. In such a case, the undersigned will be contacted via the above-listed contact information to ensure that proper arrangements are made for the athlete’s safety and supervision.

Section 3 – In Case of Emergency

Should the athlete suffer injury or illness while participating in the session, I hereby authorize the Athlete’s transport to a hospital for medical treatment.

Please sign and date below:

Parent/Guardian

Name of Parent/Guardian (please print): ______

Signature of Parent/Guardian: ______Date: ______

Athlete

Name of Athlete (please print): ______

Signature of Athlete: ______Date: ______

I, ______, hereby authorize LYFE, LLC to photograph or film my minor child and consent to the use of my child’s likeness and image

in any and all publications, advertising, news media,

and World Wide Web materials.

I understand and agree that such materials, including all negatives, positives, digital

images, and prints shall become and remain the sole property of LYFE, LLC and I shall have no right or title to such items. I agree that the University

does not owe me any compensation for the acts that I have consented to in this

agreement. I further understand and agree that these materials may be kept on file

and used by LYFE for potential future purposes and further agree to release the

organization from any and all liability arising from or in connection with the taking, use,

publication, or dissemination of such materials.

Name of Athlete (please print): ______

Signature of Athlete: ______Date: ______

Signature of Parent: ______Date:______

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