HDUB VBA General Liability Waiver & Release

HDUB VBA | General Liability Waiver & Release

This form is required before participation in HDUB VBA Volleyball Academy programs and activities, including lessons, small group training, volleyball school, public clinics, camps, team training, and volleyball-related special events. Please complete one form per participant and read the agreements carefully before signing.

Group 1: Player & Contact Information

Player's first name

Player's last name

Player's date of birth

Month

Day

Year

Player's current grade, if applicable

Player's Town

Player's School Name

Player's Club Volleyball Program

Person completing this form

Adult participant, age 18 or older

Parent or legal guardian

Parent or legal guardian's first name

Parent or legal guardian's last name

Adult participant or primary guardian's phone number

Primary guardian's email address

Confirm Primary guardian's email address

Emergency Contact's First Name

Emergency contact's full name

Emergency contact's relationship to player

Emergency contact's phone number

Group 2: Waiver, Health Authorization & Signature

A. Participant Waiver & Release of Liability

This agreement applies to participation in HDUB VBA Volleyball Academy programs operated by [FULL LEGAL BUSINESS NAME] ("Academy"), including lessons, small group training, volleyball school, public clinics, camps, team training, and volleyball-related special events.

Covered dates: September 9, 2026 - December 31, 2026

Covered locations: All HDUB VBA Training Locations

Permission to Participate

I am the adult participant or the parent or legal guardian of the participant identified in this form. I voluntarily consent to my participation, or my child's participation, in the covered volleyball instruction, drills, conditioning, training, and related activities.

Acknowledgment of Risks

I understand that volleyball involves physical activity and risks of injury. These include jumping and landing, diving, falls, collisions with other players or equipment, being struck by a ball, repetitive movements, slippery playing surfaces, and physical exertion.

Possible injuries include sprains, strains, fractures, concussions, and other head, neck, or spinal injuries. Serious incidents may result in permanent disability or death.

As an adult participant, I voluntarily accept the risks of participation to the extent permitted by law. As a parent or legal guardian, I acknowledge these risks and will discuss safety expectations with my child.

Release of the Adult Signer's Own Claims

In consideration of the Academy allowing participation, I release the Academy, Hannah Werth, and its coaches, employees, instructors, and volunteers acting in connection with the covered activities from claims belonging to me personally that I may lawfully release, arising from injury or property damage connected with that participation.

THIS RELEASE INCLUDES CLAIMS CAUSED BY THEIR ORDINARY NEGLIGENCE in providing volleyball instruction, supervision, drills, conditioning, equipment, or maintenance of the playing areas, in connection with the activities and risks described above.

If I am signing as a parent or legal guardian, this release applies only to my own individual claims that Illinois law permits me to release. It does not release my child's claims or another person's independent claims.

This agreement does not release liability for willful and wanton conduct, reckless or intentional misconduct, or any liability that cannot legally be released. Illinois law governs this agreement to the extent applicable.

I have read and agree to the Participant Waiver & Release of Liability, including the provisions that apply to me.

B. Health, Safety & Emergency Authorization

Before participation, I will inform HDUB VBA Volleyball Academy of relevant injuries, activity restrictions, allergies, emergency needs, or requested accommodations that may affect safe participation. I may contact the Academy privately to discuss this information.

The participant agrees to follow coaching instructions, use equipment appropriately, and promptly report injuries, unusual symptoms, or unsafe conditions. The participant will stop activity and notify a coach if injured or unwell.

In an emergency, I authorize Academy personnel to contact emergency services and provide first aid within their training. If I cannot be reached or cannot consent at the time, I authorize licensed healthcare professionals to provide emergency evaluation and treatment for the participant to the extent permitted by law.

The Academy may share relevant emergency information with responding healthcare professionals and will make reasonable efforts to contact the listed guardian or emergency contact.

I understand that emergency transportation and medical treatment may involve costs not covered by insurance. This authorization does not release claims concerning the cause of an injury or the care provided.

I have read and agree to the Health, Safety & Emergency Authorization.

Relevant participation restrictions or emergency needs

C. Photo & Video Authorization

HDUB VBA Volleyball Academy may photograph or video record participants during Academy programs and activities. These images or recordings may be used for educational, promotional, or social media purposes.

Do you authorize HDUB VBA Volleyball Academy to photograph or video record the participant for the purposes described above?

Yes, I authorize photo and video use

No, I do not authorize photo and video use

D. Electronic Signature

Adult participant or parent/legal guardian full name (electronic signature)

Please type your full legal name.

By typing my name and submitting this form, I confirm that I am the participant and am 18 or older, or that I am the participant's parent or legal guardian with authority to consent to participation.

I confirm that I have read the agreements above, that the information provided is accurate, and that I am signing voluntarily. I consent to use an electronic signature and intend my typed name to serve as my signature to the provisions that apply to me.

Sign here

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Date signed

Agreement version: 1.0 revision date September 9, 2026