I,______________________________________,
in consideration of being allowed to participate in the Islamic Association of
Raleigh, Indoor Soccer League 2007 (IAR-ISL
2007 ), do hereby agree to knowingly, intentionally, completely, and
irrevocably WAIVE any and all
claims, causes of action, charges, allegations, or other matters arising out
and associated with the ordinary and known risks of my participation in the
physical activity of soccer against the Islamic Association of Raleigh (IAR) or
any of its appointed administrators as the Sports & Recreation Committee
(SRC), and any parties or organizations providing facilities for such physical
activity, specifically including but not limited to the E. S. King Village, or
any and all employees, volunteers or officials of the foregoing institutions or
organizations, all members and/or officers, directors, or administrators of IAR
and/or IAR-SRC or persons operating
under the direction of or at the request of any such officers, administrators,
volunteers or employees. I further agree
to FULLY INDEMNIFY AND HOLD HARMLESS on the part of myself, my
heirs, my teammates or other representatives or agents on my behalf, the
aforementioned organizations, associations, parties, and individuals from any
and all claims arising from my participation in this activity or on my behalf
in regards to this activity.
I further represent to the officials of
IAR assigned to supervise the physical activity of soccer in which I am
participating, that I am of sound mind and in good physical health. I further certify that I have no known
medical or other deficiencies, which should prevent me or prohibit me from
participating in this physical testing.
I fully understand that this physical activity requires strenuous
physical exertion on my behalf and I am fully cognizant of any and all
potential dangers with regard to the physical exertion required in a
performance of this physical activity of soccer.
I have fully read and understood completely
the information set forth above wherein I knowingly WAIVE any and all claims against the parties stated above. My signature below and my initials in the
space beside this paragraph indicate that I have completely understood and
agree to the terms and conditions of this WAIVER
OF LIABILITY. _____ (Initials)
______________________________
(Signature)
______________________________
(Date)
(Any unauthorized changes
made to this document does not nullify the waiver)