2023 ASA Competitive Waiver
ATLANTA SWIM ASSOCIATION - COMPETITIVE PROGRAM ATHLETE WAIVER
Release of Liability and Indemnification
Form for Athletes on Competitive Swim Team
I, the undersigned parent or legal guardian, hereby verify
that the information above is correct and hereby request voluntary
participation for the above named swimmer(s) (the “Participant ”) to
participate in certain events and activities sponsored, coordinated, or
organized by ASA or SLS (collectively, the “ASA Programs ”). In
consideration of the Participant being allowed to participate in the ASA
Programs, the undersigned, individually and on behalf of the Participant and
the undersigned’s spouse, heirs, successors, next of kin, personal and legal
representatives, and permitted assigns, hereby acknowledges, understands,
confirms, and agrees to the following:
1.This
Release of Liability and Indemnification Form (this “Agreement ”) is
valid and will continue in full force and effect while the Participant is
participating or otherwise involved in the ASA Programs and will survive thereafter.
2.I
consent to the Participant’s participation in the ASA Programs and acknowledge
that the Participant and I fully understand that such participation may involve
risk of serious injury, illness and/or death, including, without limitation,
permanent disability and losses or damages which may result not only from the
Participant’s or my own actions, inactions, or negligence, but also from the
actions, inactions, or negligence of third parties (including the Releasees),
the condition of the facilities, equipment, or areas where any ASA Program is
being conducted or held, and/or the rules of play of the ASA Programs. While
particular rules, equipment, and personal discipline may reduce or mitigate
such risk, such risk to the Participant will always be present. I understand
that if I have (or the Participant has) any risk concerns, I should discuss the
risks associated with the Participant’s participation with authorized
representatives of ASA or SLS before I sign this Agreement and before the
Participant begins participating in the ASA Programs.
3.I
knowingly and freely assume all risks, both known and unknown, even if arising
from the negligence of the Releasees or others, and assume full responsibility
for the participation of the Participant in the ASA Programs. I acknowledge
that participating in the ASA Programs involves strenuous physical activity. All
exercises, workouts, training, and activities that are part of the ASA Programs
are at the Participant’s sole risk.
4.In
consideration of allowing the Participant to participate in the ASA Programs, I
hereby release and hold harmless Atlanta Swim Association, LLC (“ASA ”) and
Summer League Swimming LLC (“SLS”)., and each of their affiliates, officers,
directors, managers, members, partners, shareholders, volunteers, employees,
agents, counsel, and representatives, and all sponsors, other participants,
facility and equipment owners and lessees, advertisers, and other persons
involved in the ASA Programs (collectively, the “Releasees ”), of and
from, and do hereby discharge and waive, any and all claims, actions, demands, causes
of action, proceedings, losses, damages, liabilities, costs, and expenses of
whatever kind or nature (collectively, “Losses ”) that the Participant
may have, sustain, or incur with respect to any and all damage, illness, disability,
death and/or injury, of any type, arising out of or incident to the Participant’s
involvement or participation in the ASA Programs, whether arising from the negligence
of the Releasees or otherwise, to the fullest extent permitted by law.
5.I
have reviewed and fully understand the concussion information set forth on Exhibit
A attached hereto and incorporated herein by this reference.
6.I
agree to fully comply with all rules, instructions, procedures, and guidelines
of ASA and SLS and all customary terms and conditions for participation in the
ASA Programs. I acknowledge that by registering my Participant that I am providing personal information for that Participant to ASA. If I have any concern (or observe any unusual signs or
indications) in the readiness of the Participant for participation in the ASA
Programs, I will immediately remove the Participant from participation and
bring such issue to the attention of the nearest ASA Program official.
7.ASA and SLS have urged the Participant to obtain a physical examination from a
licensed health care professional before using any pool or exercise equipment
or participating in any ASA Program. I hereby certify that the Participant is in good health and
has no physical or mental condition that would prevent participation in the ASA
Programs. I agree to use the Participant’s personal medical insurance as a
primary medical coverage payment if accident or injury occurs. I consent to
emergency medical treatment in the event such care is required.
8.I acknowledge the
contagious nature of COVID-19 and voluntarily assume the risk that the
Participant, my family (including children), and I may be exposed to or
infected by COVID-19 while onsite at any ASA Program or ASA or SLS events, and that such exposure or infection may result in personal
injury, illness, permanent disability, and/or death. I understand that the risk
of becoming exposed to or infected by COVID-19 at any ASA Program or ASA or SLS events may result from the actions, omissions, or negligence of myself
and others, including, but not limited to, the Releasees. I voluntarily agree
to assume all of the foregoing risks and accept sole responsibility for any
injury, illness, permanent disability, death, damage, and/or Losses that the
Participant, my family (including children), or I may experience, sustain, or
incur in connection with any attendance at any ASA Program or ASA or SLS events (collectively, “Claims ”). I hereby release, covenant not
to sue, discharge, and hold harmless the Releasees of and from the Claims,
including all Losses of any kind arising out of or relating thereto. I
understand and agree that this release includes any Claims based on the actions,
omissions, or negligence of any Releasees and whether a COVID-19 infection
occurs before, during, or after participation in any ASA Program or ASA or SLS events.
9. I acknowledge and understand that the ASA Championship meet is likely to be webcast and that my child may be part of that webcast.
10.I
agree that this Agreement extends to all acts of negligence by the Releasees
and is intended to be as broad and inclusive as is permitted by law and that if
any portion thereof is held invalid, illegal, or unenforceable, it is agreed
that the balance shall, notwithstanding, continue in full legal force and
effect and such invalidity, illegality,
or unenforceability shall not affect any other provisions of this Agreement.
This Agreement shall be construed as if such invalid, illegal, or unenforceable
provision had never been contained herein. Upon such determination that any
term or other provision is invalid, illegal, or unenforceable, the court or
other tribunal making such determination is authorized and instructed to modify
this Agreement so as to effect the original intent of the parties as closely as
possible so that the waivers, releases, assumptions, and other matters
contemplated herein are effectuated as originally contemplated to the fullest
extent possible.
11.I
represent and warrant that: (a) I am the lawful parent or legal guardian of the
Participant, (b) I have full authority to consent to the Participant’s
participation in the ASA Programs, (c) I am authorized to execute this
Agreement on behalf of the Participant, and (d) no other person’s authorization
or consent is required to execute this Agreement or grant the rights herein.
12.I
further represent and warrant that: (a) I have read this Agreement, (b) I fully
understand and agree to all terms and provisions herein, (c) I have had all my
questions answered to my satisfaction, (d) I have had an opportunity to review
this Agreement with an attorney, (e) I understand that the Participant has the
choice of not participating in the ASA Programs, (f) the Participant and I have
given up substantial rights by signing this Agreement, and (g) I am signing
this Agreement freely and voluntarily without any inducement.
13.Membership
in ASA and SLS is a privilege granted by ASA and SLS. It is not a right. ASA
and SLS at its sole discretion reserves the right to accept or reject any
applicant(s) for membership. Membership
in any category may be granted only after an application is submitted and
approved. By submitting an application, the applicant agrees to comply with all
the provisions of the ASA and SLS Handbook (https://summerleagueswimming.com/sls-handbook/ )
14.This Agreement
shall be governed by and construed in accordance with the internal laws of the
State of Georgia without giving effect to any choice or conflict of law
provision or rule. This Agreement may only be amended, modified or supplemented
by an agreement in writing signed by an authorized representative of ASA or SLS. A signed copy of this Agreement delivered by facsimile, e-mail or
other means of electronic transmission shall be deemed to have the same legal
effect as delivery of an original signed copy of this Agreement.
If the swimmer is a minor, I certify that I have the
swimmer’s parent's or guardian's consent for the swimmer to become an SLS
Member.
I accept all terms and conditions for this SLS membership
application as laid out by the SLS Handbook and this application.
I hereby certify that all information I have provided is
accurate, my name (above) is correct, and I am authorized to apply for
membership for the youths in this application.
I understand that there are no refunds issued for
cancellations.
By entering my name above and clicking the box below, I
hereby authorize SLS to create the requested individual membership, accept and
acknowledge all terms and conditions presented to me during the application
process.
NOTE: THIS MUST BE SIGNED BY
THE PERSON APPLYING FOR MEMBERSHIP OR A PARENTALLY APPROVED REPRESENTATIVE FOR
YOUTH APPLICANTS.
EXHIBIT
A
Concussion Awareness
Parent/Participant
Concussion Information Sheet: A concussion is a type of traumatic brain injury
that changes the way the brain normally works. A concussion is caused by a
bump, blow, or jolt to the head or body that causes the head and brain to move
rapidly back and forth. Even a “ding,” “getting your bell rung,” or what seems
to be a mild bump or blow to the head can be serious.
WHAT
ARE THE SIGNS AND SYMPTOMS OF CONCUSSION?
Signs and symptoms of
a concussion can show up right after the injury or may not appear or be noticed
until days or weeks after the injury. If an athlete reports one or more
symptoms of a concussion listed below after a bump, blow, or jolt to the head
or body, he or she should be kept out of play the day of the injury and until a
health care professional, experienced in evaluating for concussions, says he or
she is symptom-free and it is okay to return to play.
Did You Know?
Most
concussions occur without loss of consciousness.
Athletes
who have, at any point in their lives, had a concussion have an increased
risk for another concussion.
Children
and teens are more likely to get a concussion and take longer to recover
than adults. SIGNS
OBSERVED BY COACHING STAFF SYMPTOMS REPORTED BY ATHLETES
Appears
dazed or stunned
Headache
or “pressure” in head
Is
confused about assignment or position
Nausea
or vomiting
Forgets
an instruction
Balance
problems or dizziness
Is
unsure of game, score, or opponent
Double
or blurry vision
Moves
clumsily
Sensitivity
to light
Answers
questions slowly
Sensitivity
to noise
Loses
consciousness (even briefly)
Feeling
sluggish, hazy, foggy, or groggy
Shows
mood, behavior, or personality changes
Concentration
or memory problems
Cannot
recall events prior to hit or fall
Confusion
Cannot
recall events after hit or fall
Just
not “feeling right” or “feeling down” CONCUSSION
DANGER SIGNS
In rare cases, a
dangerous blood clot may form on the brain in a person with a concussion and
crowd the brain against the skull. An athlete should receive immediate medical
attention if after a bump, blow, or jolt to the head or body, he or she
exhibits any of the following danger signs:
One
pupil larger than the other
Is
drowsy or cannot be awakened
A
headache that not only does not diminish, but gets worse
Weakness,
numbness, or decreased coordination
Repeated
vomiting or nausea
Slurred
speech
Convulsions
or seizures
Cannot
recognize people or places
Becomes
increasingly confused, restless, or agitated
Has
unusual behavior
Loses
consciousness (even a brief loss of consciousness should be taken
seriously)
WHY
SHOULD AN ATHLETE REPORT THEIR SYMPTOMS?
If an athlete has a
concussion, his or her brain needs time to heal. While an athlete’s brain is
still healing, he or she is much more likely to have another concussion. Repeat
concussions can increase the time it takes to recover. In rare cases, repeat
concussions in young athletes can result in brain swelling or permanent damage
to their brain. They can even be fatal.
WHAT SHOULD YOU DO
IF YOU THINK YOUR ATHLETE HAS A CONCUSSION?
If you suspect that
an athlete has a concussion, remove the athlete from play and seek medical
attention. Do not try to judge the severity of the injury yourself. Keep the
athlete out of play the day of the injury and until a health care professional,
experienced in evaluating for concussion, says he or she is symptom-free and it
is okay to return to play. Rest is key to helping an athlete recover from a
concussion. Exercising or activities that involve a lot of concentration, such
as studying, working on the computer, or playing video games, may cause
concussion symptoms to reappear or get worse. After a concussion, returning to
sports and school is a gradual process that should be carefully managed and
monitored by a health care professional. Remember, concussions affect people
differently. While most athletes with a concussion recover quickly and fully,
some will have symptoms that last for days, or even weeks. A more serious
concussion can last for months or longer. It is better to miss one game than
the whole season.
For more information
on concussions, visit: https://www.cdc.gov/headsup/index.html .
I HAVE READ THIS WAIVER AND I AGREE TO ITS TERMS.
*
Enter your initials to indicate acceptance:
*
