I,______________________________________,
in consideration of being allowed to participate in the Islamic Association of
Raleigh, Men’s Basketball League 2007 (IAR-MBL
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 basketball 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 basketball 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 basketball.
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)