GREAT VALLEY COMMUNITY ORGANIZATION
RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT:

IN CONSIDERATION of being permitted to participate in the GVCO Pickleball Program:

I. I assume all risks and hazards incidental to participation in this activity. I hereby release GVCO from any and all liability which may arise from any injury from whatever reason to myself. Further, in considerations of my participation in the GVCO Program, I agree to INDEMNIFY and hold GVCO Affiliated Organizations, the Organizers, Sponsors, Supervisors, Participants, Coaches, Referees, Land owners and any persons transporting this player to and from GVCO and related activities, HARMLESS for any claim for any injury, damage, loss, costs, and/or expenses of any kind arising out of this player's participation in these activities, whether such damages are the result of negligence or for any other reason or cause. I also agree to discharge forthwith, on request of GVCO and its Authorized Representatives, each and every obligation or claim which shall be made, assigned or apportioned against GVCO or its Authorized Representatives by any party by virtue of absolutely any injury or damage caused to this player.

II. In the event of injury or sickness, I authorize GVCO representatives to transport and admit myself to any convenient hospital or similar facility for emergency medical treatment. My emergency contact authorizes said Hospital to commence treatment.

 III. Great Valley Community Organization (GVCO) would like to post pictures to a photo gallery on its website  www.gvco.org. Photographs taken may be used in future public materials (including but not limited to posters, brochures, advertisements, slide shows, social media and the website). By signing below, I g ive permission to GVCO to use any and all photographs taken of myself for posting on the website or printed material. I hereby waive any rights or interests that I might have in any or all images.
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Participant's First Name
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Participant's  Last Name *
Participant's Email Address
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Participant's Contact Phone
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Participant's Level of Expertise
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I hereby acknowledge adequate personal medical insurance coverage for myself. No one will be permitted to play without providing to GVCO evidence of insurance coverage.  

Name of Participant's Insurance Company
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Participant's Insurance Policy Number
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Participant's Emergency Contact Phone Number
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Participant's street address
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Participant's City, State, Zip of mailing address
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Participant's Township of Residence
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I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS. Name of participant: *
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