Adult Athletics Participant Waiver

Greensboro Parks and Recreation Department Participant Registration & Waiver Form

Accessibility Accommodation Request: The City of Greensboro Parks & Recreation Department welcomes the participation of all individuals, including those with disabilities or special needs, and is committed to complying with the ADA by providing reasonable accommodations to facilitate participation in our programs. To ensure that reasonable accommodations are in place, accommodation requests should be received at the time of registration. If you require assistance for participation in our programs or use of our facilities, please call 336-373-2626.

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Program Details

Release and Indemnity Agreement: I understand that participating in the class (es) or program (s) selected involves risk of injury. These risks include inclement weather, accidents while traveling, equipment problems or failures, contacts with actions of other participants, slips/trips/falls, and musculoskeletal injuries, among others. I choose for myself or for my child to participate in the selected programs despite the risks. By agreeing to the registration form, I acknowledge all risks of injury, illness and death and affirm that I have assumed all responsibility of injury, illness or death in any way connected with participation in the program. I also agree for myself and for any child participant to follow all rules and procedures for the program and to follow reasonable instructions of the teachers and supervisors of the program. In return for the opportunity to participate in this program, I agree for myself and for my heirs, assigns, executors and administrators to release, acquit, waive and forever discharge any legal rights I may have to seek payment or relief of any kind from the City of Greensboro, its officers, employees, agents or its volunteers for injury, illness, death or property loss resulting from this program. If I am registering a child for a program, I agree that I am a parent, legal guardian, or am otherwise responsible for the child whose application I am submitting and that I release, waive, and discharge any legal rights that I may request on behalf of the child participant in the program. I also agree not to sue the City, its officers, employees or agents and agree to indemnify the City for all claims, damages, losses, or expenses, including attorney’s fees, if a suit is filed concerning an injury, illness or death to me or my child resulting from participation in the program. Permission is given for any emergency medical treatment which might become necessary and I agree to be responsible for the expense of medical treatment or service.

The City of Greensboro recommends that all participants complete an annual physical and consult a health care professional to assess their ability to participate in athletic program (s).


Image Release: I, the undersigned, hereby consent to allow the exclusive use of, and relinquish all rights to, photographs, recordings and reproductions in any manner (including but not limited to the use of photos, video and audiotapes) of the likeness, voice, and/or activities of the participant and further authorize the City of Greensboro, its agents or assigns, to make unlimited use of such reproductions, including but not limited to print and/or electronically, broadcasting of the reproduction over radio, television, and on the internet with or without your name for any lawful purpose. I acknowledge that no compensation will be provided for such use by the City. I understand that this Release shall remain in effect unless a subsequent written notification is provided to the City.

Non-Discrimination Policy: It is the policy of the City that the City will not discriminate on the basis of sex, race, gender, color, ethnicity, national origin, age, familial status, marital status, military status, political affiliation, religion, physical or mental disability, genetic information, sexual orientation, gender expression, or gender identity in authorizing or making available the use of city facilities or in the delivery of city programs, services or activities.

READ BEFORE SIGNING:In consideration of being allowed to participate in any way in a City of Greensboro Parks and Recreation program, related events and activities, the undersigned acknowledges, appreciates, and agrees that:1. The risks of injury and illness (communicable diseases such as MRSA, influenza, and COVID-19) from the activities involved in this program are significant, potentially life-threatening, and while particular rules, equipment, and personal discipline may reduce these risks, the risks of serious injury and illness do exist.2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation.3. I willingly agree to comply with the stated and customary terms and conditions for participation. If,however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately.4. I acknowledge that I am aware that there are risks to me of exposure to directly or indirectly arising out of, contributed to, by, or resulting from an outbreak of any and all communicable disease,including but not limited to, the virus “severe acute respiratory syndrome coronavirus 2 (SARS-CoV2)”, which is responsible for Coronavirus D