Jose
Martinez - Owner & Head Coach
105 SI JohnsonRd., P. 0. Box Box 0742, Sheridan, IL 60551
(630) 862-2790
Program Waiver and Release Of All Claims:
Please read this form carefully and be aware that signing up and participating
in the program(s), you will be expressly assuming the risk and legal
liability and waiving and releasing all claims for injuries, damages
or loss which you or your minor child/ward might sustain as a result
of participating in any, and all activities connected with and associated
with this program(s):including transportation services, when provided.
I recognize and acknowledge that there are certain risks of physical
injury to participants in this program(s), and I voluntarily agree to
assume the full risk of any and all injuries, damages, or loss regardless
of the severity that my minor child/ward or I may sustain as a result
of said participation. I further agree to waive and relinquish all claims
I, or my minor ward/child may have (or accrue to me or my child/ward)
as a result of participating in this program(s) against the Martinez
Fox Valley Elite Wrestling Club. including its officials, agents, and
volunteers (hereafter collectively referred to as the Martinez Fox Valley
Elite Wrestling Club.)
I do hereby fully release and forever discharge the Martinez Fox Valley
Elite Wrestling Club from any and all claims for injuries, damages,
or loss that my minor child/ward, or I may have or which may accrue
to me or my minor child/ward and arising out of, connected with, or
any way associated with this program(s).
I have read and fully understand the above important information, warning
of risk and assumption of risk and waiver and release all claims. If
registering a minor participant, I further attest that I have read the
above to my minor child/ward.
Medical Power of Attorney:
I appoint the Martinez Fox Valley Elite Wrestling Club, its coaches
and directors as my attorney to act on my behalf for the purposes of
securing medical treatment for the above child, this special power of
attorney shall only be valid from September 1, 2007 through August 31,
2008.
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