F Friends s with Benef fits Kic ckball, LLC

Accide ent Waiv ver and R Release of o Liabilit ty

Iack knowledgeth hatthisathle eticeventca anbeanextr remetestofapersonsp physicalandmentallimit tsandcarrieswith itthepotentialfor f death,seriousinjurya andproperty yloss.Therisksinclude,butarenotlimited l to,th hosecausedby terra ain, facilities s, temperatu ure, weather r, condition of o athletes, equipment, vehicular traffic, lack of f hydration or o the actio ons of other r people inc cluding, but not limited to, particip pants, specta ators, coach hes, event officials o and event mon nitors. All of f these risks and those not specifically listed are inherent to athletics. I realize that liability may y arise from m negligence e or carelessness on the part of the persons or entities bein ng released as well as fr rom dangero ous or defe ective equipm ment or pro operty owne ed, maintain ned or contr rolled by them or because of their r possible lia ability with houtfault. Icer rtifythatIam mphysicallyfit, f havesuff ficientlytrain nedforpartic cipationinth heeventand dhavenotbe eenadvised othe erwisebyaqualified q med dicalperson. . knowledgeth hatthisAccid dentWaiverandRelease eofLiabilityform f willbeusedbytheeventholde ers,sponsors s Iack andorganizers,in i whichIma ayparticipat teandthatit twillgovernmyactionsa andresponsibilitiesatsa aidevents. Inco onsiderationofmyregist trationandp permittingme m toparticip pateinthisev vent,Ihereb bytakeactionformyself, , myexecutors, e ad dministrator rs,heirs,next tofkin,succ cessors,andassignsasfo ollows: (A) W Waive, Relea ase and Disch harge from a any and all liability for my m death, dis sability, personal injury, property damage, prop perty theft or actions of any kind wh hich may hereafter accrue to me including my tra aveling to an nd from this event the following f en ntities or per rsons: Friend ds with Bene efits Kickball, , LLC, their d directors, off ficers, emplo oyees, volun nteers, repr resentatives, and agents s as well as s the event holders, eve ent sponsor rs, event dir rectors, even nt volunteer rs; (B) Inde emnifyandHold H Harmles sstheentitie esorpersons smentioned dinthisparagraphfrom anyand allliabilitiesorclaims c mad deasaresult tofparticipationinthisevent, e wheth hercausedby ytheneglige enceofrelea aseesorothe erwise. Iher rebyconsent ttoreceivemedical m treat tmentwhich hmaybedee emedadvisableintheev ventofinjury y,accidentan nd orill lnessduringthisevent. I und derstand tha at during this event or related r activities, I may be b photographed. I agree to allow my m photo, vid deo or film likeness to be used for any legitim mate purpos se by the ev vent holders, producers, , sponsors, organizers o a and or assig gns. aiverandReleaseofLiab bilityshallbeconstruedbroadly b topr rovidearelea aseandwaiv vertothe TheAccidentWa max ximumextentpermissible eunderthelaws l oftheState S ofArizo ona. __________ ___________ ___________ ___________ _,herebycertifythatIha avereadthis sdocumentandIunders stand I____ (Plea aseprintfirstand dlastname) andagreetoitscontent. ___________ ___________ __________ ___________ ____ _______ ___________ ________ ____ Signature Date ___________ ___________ __________ ___________ _____ ____ Date eofBirthMonth, M Date,Year