Medical Release & Liability Waiver

Athlete First & Last Name

Parent First & Last Name

Athlete DOB

Emergency Contact Name & Number

Secondary Emergency Contact Name & Number

Known Allergies and/or Medical Conditions

Medical Release and Liability Waiver: I certify that the above named athlete is physically capable and able to fulfill requirements needed to participate in all aspects of the Diamond Athletics, LLC (hereinafter referred to as “Diamond Athletics”) program and hereby give consent for him/her to participate in all aspects of Diamond Athletics’ program. I Hereby release, discharge, hold harmless, covenant to indemnify and not to sue Diamond Athletics, it’s directors, officers, employees, coaches, volunteers, managers, agents, sponsors, shareholders, and any associated personnel, from any and all liability to each of the undersigned, his/her heirs or next of kin for any and all against any claim by or on behalf of the participant as a result of participation in Diamond Athletics’ program(s) and/or being transported to or from the same, which participation, after careful consideration I hereby authorize, and which transportation I hereby authorize. This release includes any claims of negligence, and is intended to be as broad as is permissible under New York State Law.

Statement of Hazards of Participating in Cheerleading/Tumbling: I acknowledge and fully understand that each participant will be engaging in activities that involve serious risk of injury, including but not limited to, death, serious neck, head and spinal injuries which may result in complete or partial paralysis; brain damage; serious injury to virtually all internal organs; muscular skeletal system; and serious injury or impairment to other aspects of the body, general health and well-being and any other unknown risks not reasonably foreseeable at this time. I assume all the foregoing risk and accept financial responsibility for the damages following any such injury.

Medical Treatment Release: If a medical emergency should arise during my child’s participation with Diamond Athletics, LLC (hereinafter referred to as “Diamond Athletics”) at a time when I am not personally present so as to be consulted regarding his/her care; I hereby authorize any agent of Diamond Athletics, on my behalf to take whatever measures are necessary to ensure that he/she is provided with any emergency medical treatment including hospitalization, which Diamond Athletics deems advisable in order to protect his/her health and well-being and I agree to be financially responsible for the cost of such assistance and/or treatment.

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