My child or “I” if aged 18 or older (either being the “Participant”) wishes to participate in
the Norcross Blue Devil Water Polo program “Program”.
I have read the Water Polo COVID practice guidelines and agree to abide by these rules.
I also understand that no steps can be 100% in preventing the Covid-19 or any other
illness from being spread. I accept that it is my decision to allow my child/ children to
participate under the current world situation.
The undersigned certifies that the Participant is in good health and has no physical or
other impediment which would endanger the Participant while participating in the
Program, and that the Participant has been released and authorized by a doctor to
participate in the Program. The undersigned acknowledges and agrees that activities in
the Program have inherent risks and has full knowledge of the nature and extent of the
risks associated with these activities and that they could include serious injury and death.
The Program can result in serious injury or death including drowning from any number of
causes including incidents with other players, of falls on deck etc. Any incident in the
Program can lead to serious injury, head injuries, paralysis and death. The undersigned
knowingly and freely assumes all such risks on behalf of the Participant. In consideration
of the Participant’s participation in these activities, the undersigned hereby (on behalf of
myself, my legal representatives, parents, heirs, executors, administrators, and assigns)
releases and forever discharges the Norcross Blue Devil Water Polo program including
its officers, directors, volunteers, agents and coaches from and relinquish and forever
waive, any and all claims and causes of action arising out of participation in the Program
for negligence, gross negligence, and such other actionable conduct resulting in personal
or bodily injury, property damage or death.
By registering the above-named Athlete for the Norcross Water Polo, Inc. program, I and my child
(the Athlete) recognize and acknowledge that water polo is a strenuous, co-ed, contact sport. The
Athlete is able to swim in deep water.
YES, I AGREE.
Enter your initials to indicate acceptance: