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In consideration of participation in Lena Sports Association Athletics and any and all activities associated therewith, the undersigned, as participant, and the undersigned, as parent(s) and/or guardian(s) of the participant (hereinafter collectively referred to as "Releasers"), individually and collectively, for himself and for his or her personal representatives, assigns, heirs, and next of kin, hereby releases, waives, discharges and covenants not to sue the Lena Sports Association, Inc., and any of its officers, directors, agents and/or employees (hereinafter collectively referred to as "Releases"), from any and all liability to the undersigned, his or her personal representatives, assigns, heirs, and next of kin for all loss or damage, and any claim or demands therefore, on account of injury to the person or property or resulting in death, whether caused by the negligence of releases or otherwise while participant is engaged in any activity associated with or conducted bythe Lena Sports Association, Inc. The Lena Sports Association will not offer any insurance coverage to the participants.
The undersigned further acknowledges having read this document in its entirety, and that he or she understands its contents and the purpose for which it is being executed. In event that my son/daughter sustains injury or illness during the activities and trips conducted by the Lena Sports Association, I authorize whatever medical or surgical treatment is deemed advisable by available medical personnel. In understand the Lena Sports Association representative in charge of the activities will make a reasonable attempt to contact me and this authorization is intended to apply to situations that require prompt attention.
After submitting this form, you may pay using PayPal on the following confirmation screen, or you may pay by check and mail the fee to: Lena Sports Assoc. P.O. Box 150 Lena, IL 61048
Lena Sports Assoc. P.O. Box 150 Lena, IL 61048
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