Office use only: PO Date: ______ Date recv’d: ______ CK#: __________ Amt Pd: __________

                                     Waiver & Release of Liability Basehor Athletic Association, Inc.                                        Basehor Athletic Association, Inc. Basehor, KS 66007

Disclaimer: The Basehor Athletic Association is not responsible for any injury (or loss of property) to any person suffered while playing, practicing, or in any other way involved any athletic programs for any reason what so ever. including ordinary negligence on the part of the Basehor Athletic Association, their agents, officers, or employees.

In consideration of my participation, I hereby release and convenient not-to-sue the Basehor Athletic Association, their officers, volunteers, employees, or agents from any and all present and future claims resulting from ordinary negligence on the part of the Basehor Athletic Association or others listed for property damage, personal, injury, wrongful death, arising as a result of my engaging in or receiving instruction in Sports Activities. Or any activities incidental thereto, wherever, whenever, however the same may occur. I hereby voluntarily waive any and all claims resulting from ordinary negligence, both present and future, which may be made by family estate heirs, assigns, or me.

Further, I am aware the sport of ___________________ may involve severe cardiovascular stress and possible violent contact. I understand the above sport involves certain risks including, but not limited to death, serious neck and spinal injuries resulting in complete or partial paralysis brain damage, and serious injury to virtually all bones, joint, muscles and internal organs and that equipment provided for protection may be inadequate to prevent serious injury. I further understand that the above listed sport involves a particularly high risk of knee, head, and neck injury. In addition, I understand that participation in activities sponsored by the BAA involves activities incidental thereto, including, but not limited to, travel to and from site of other participants. I am voluntarily participating in this activity with knowledge of the danger involved and hereby agree to accept any and all inherent risks of property damage, personal injury and death.

I further agree to identify and hold harmless the BAA, their governing boards, volunteers, and others listed for any and all claims arising as a result of my engaging in or receiving instruction in the above listed activities or any activities incidental thereto, wherever, whenever, or however the same may occur.

I understand that this waiver is intended to be as broad and inclusive as permitted by the laws of Kansas and agree that if any portion is held invalid, the remainder of the waiver will continue in full legal force and effect. I further agree that the venue for any legal proceedings shall be in the State of Kansas.

I affirm that I am of legal age and am freely signing this agreement. I have read this form and fully understand that by signing this form I am giving up legal rights and/or remedies, which may be available. to me for the ordinary negligence of the BAA., or any of the parties listed above.

_____________________________________________________________________________________________            Signature of Participant

_____________________________________________________________________________________________                    Signature of Parent (of participant if under 18)