3rd Avenue Sports (DBA) Collegeville Sports Academy (CSA)
ADULT PARTICIPANT (INCLUDING COACHES) WAIVER & RELEASE FORM

In order that I be allowed to participate in any activities at 3rd Avenue Sports (DBA Collegeville Sports Academy), I agree to all of the terms
of this Waiver. I have the authority to enter this Waiver on behalf of myself. This waiver covers my activities at CSA at
any time, during calendar years 2023-2024, and in the future beyond calendar year 2024.

I acknowledge that some activities have certain dangers and that accidents may occur, and that I may sustain injuries,
death or property damage, as a consequence thereof. I hereby knowingly & voluntarily assume all risk of injury while I am
participating in the activities. Understanding the inherent risks in participating, I represent to the best of my knowledge, I
have no medical, physical, and/or emotional health conditions which would hinder against me participating. I also certified
that I am physically fit, and I have been sufficiently trained to participate in the activities.

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19
is extremely contagious and is believed to spread mainly from person-to-person contact from being in close proximity with
others. As a result, federal, state and local governments and federal and state health agencies recommend social
distancing and have, in many locations, prohibited the congregation of groups of people. CSA and its employees cannot
guarantee that you, your player, or others associated with you will not become infected with COVID-19 (or any illness). By
signing this agreement, you acknowledge on behalf of yourself, your player(s), your family, and anyone else connected to
you the contagious nature of COVID-19 and voluntarily assume the risk for all involved of being exposed to or infected by
COVID-19 (or any illness), and that such exposure or infection may result in personal injury, illness, permanent disability
and death. You understand that there is risk of becoming exposed to or infected by COVID-19 (or another illness). You
understand and agree that this release includes any claims based on the actions, omissions, or negligence of CSA and is
employees and anyone else associated with CSA, whether a COVID-19 infection (or other infection) occurs before, during
or after participating in any activities on CSA’s premises or otherwise associated with CSA.

In consideration of the request and permission to participate in any activities at CSA, I hereby agree on my own behalf, to
release and forever discharge CSA, as well as its owners, agents, employees, heirs and executors from any and all liability
for injuries, death or property damage, arising or resulting from or in any other way connected to my participation. The
terms of this waiver apply to myself, my children, our heirs, executors, administrators, assigns, successors, spouse,
personal representatives, agents, legatees, other parents, and all family members. I agree that this Waiver shall cover my
participation in any and all activities, including but not limited to, practice or instructional sessions, and any activity taught
by the coaches, league representatives or other instructors or agents.

I agree to indemnify CSA, and hold CSA harmless, from any and all liability (including attorney’s fees whether paid directly
or indirectly) arising out of, whether directly or indirectly, my involvement or participation in activities.

I give authority to CSA to obtain on my behalf in any emergency treatment. In case of sickness, accident, illness or injury
CSA has my express permission to secure, at my express, such medical attention as is deemed necessary in the sole
discretion of CSA.

Collegeville Sports Academy (CSA) has my permission to use my or my child’s photograph publicly to promote the
facility. This waiver gives CSA permission to use photographs and/or video recordings of any events that takes place on
CSA property. I understand that the images may be used in print publications, online publications, presentations,
websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by
reason of such use. I waive the right to approve the final product. I agree that all such portraits, pictures, photographs,
video and audio recordings, and any reproductions thereof, and all plates, negatives, recording tape and digital files are
and shall remain the property of CSA. I hereby release, acquit and forever discharge CSA from any and all claims,
demands, rights, promises, damages and liabilities arising out of or in connection with the use or distribution of said
photographs and/or video recordings, including but not limited to any claims for invasion of privacy, appropriation of
likeness or defamation.

Participant Name:

Participant Address:

Participant Phone:

Participant Email:

Organization/Team:

I have read and understand all of the information presented to me in this document. I agree to accept and abide by the rules & regulations of CSA.

Participant's Signature