2021 HOLIDAY ID CAMP WAIVER

INDEMNIFICATION AGREEMENT
WAIVER AND RELEASE OF ALL CLAIMS
PERMISSION TO SECURE TREATMENT


TOP STUDENT ATHLETE RECRUITING HOLIDAY ID CAMP
TSA RECRUITING HOLIDAY ID CAMP | DECEMBER 29, 2021


Please read this form carefully and be aware that by participating in the Top Student-Athletes College Soccer Holiday ID Camp on December 29, 2021 (hereinafter Event) you will be waiving and releasing all claims for injuries, agreeing to indemnify, hold harmless and defend Dan Rothert Student Athlete Advising, LLC from all claims arising out of such injuries or illnesses even if caused by Dan Rothert Student Athlete College Advising, LLC and authorizing Dan Rothert Student Athlete Advising LLC to obtain emergency healthcare at your expense.


I, on behalf of myself and, on behalf of any child/ward of mine participating in the Event as well as any parent/guardians of such child/ward (hereinafter individually and collectively referred to as “Participant”), acknowledge understanding of the requisite skills and qualifications necessary to properly and safely participate in the Event and hereby agree to assume the full risk of any injuries, illnesses, including death, damages or loss regardless of severity, which Participant may sustain as a result of, arising out of, connected with, or in any way associated with the Event.


Participant agrees to waive and relinquish all claims Participant may have as a result of the Event against Dan Rothert Student Athlete Advising LLC and its employees and agents and does hereby fully release and discharge Dan Rothert Student Athlete Advising LLC and its employees and agents from any and all claims for injuries, including death, damage or loss which Participant may have or which may accrue to Participant as a result of, or arising out of, connected with, or in any way associated with the Event, even if caused by the negligence of Dan Rothert Student Athlete Advising LLC , its employees or agents.


Participant further agrees to INDEMNIFY AND HOLD HARMLESS AND DEFEND Dan Rothert Student Athlete Advising LLC and its employees and agents from any and all claims for injuries, including death, damages and losses sustained by Participant as a result of, arising out of, connected with, or in any way associated with the Event, even if caused by the negligence of Dan Rothert Student Athlete Advising LLC , its employees or agents.


Participant further understands that Dan Rothert Student Athlete Advising LLC does not carry insurance for injuries or illnesses sustained by Participant. Therefore, Participant must look to their own health insurance policy for any injuries sustained in connection with or arising out of this Event. Participant’s failure to purchase health insurance coverage does not make r Dan Rothert Student Athlete Advising LLC responsible for payment of medical or other expenses.


In the event of an emergency, Participant authorizes Dan Rothert Student Athlete Advising LLC to secure any treatment deemed necessary from any licensed hospital, physician, and/or medical personnel and agrees to be responsible for payment of any and all services rendered.


DISEASES INCLUDING COVID-19

In consideration of being allowed to participate on behalf of Dan Rothert Student Athlete Advising LLC athletic program and related  events and activities, the undersigned acknowledges, appreciates, and agrees that:  

1. Participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and  COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and,  2. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the releasees or others,  and assume full responsibility for my participation; and,  

3. I willingly agree to comply with the stated and customary terms and conditions for participation as regards protection against infectious  diseases. If, however, I observe and any unusual or significant hazard during my presence or participation, I will remove myself from  participation and bring such to the attention of the nearest official immediately; and,  

4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Dan Rothert Student Athlete Advising LLC, officials, coaches, members, agents, and/or employees, other participants,  sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“releasees”), while  participating in activities of any kind whether sponsored by or under the supervision of. and with respect to any and all illness, disability,  death, or loss or damage to person or property, whether arising from the negligence of Dan Rothert Student Athlete Advising LLC releasees or otherwise, to the fullest extent permitted by law.


Participant Name(Required)
Address(Required)
Must be signed by Parent/Guardian if Participant is a minor.
Parent/Guardian Name(Required)