506 Fairgrounds Rd.
West Kingston, RI 02892
401-594-0265
Anchorsportsri@gmail.com
M-F 9AM - 10PM
Sat - Sun 8am-9pm
Home
About Us
Instructors
Cage Rentals
Golf Rentals
Menu
Home
About Us
Instructors
Cage Rentals
Golf Rentals
PRIVATE LESSON PLANS
Anchor Sports, LLC - Waiver
Please enable JavaScript in your browser to complete this form.
Participant Name
*
First
Last
Parent/Guardian Name
First
Last
D.O.B. of Participant
Address
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Email
Usage Type:
*
Membership
Clinic
Indiv. Rental
Team Rental
Private Lesson
Little Anchors
Birthday Party
Special Event
Golf Experience
Cornhole
Live BP
Team/Coach's name (if applicable)
First
Last
I acknowledge that the sport I am voluntarily signing up for, and/or activities I am attending, and/or any other activity that I am signing up for on behalf of myself and/or my minor child are inherently dangerous to participate and/or watch and I and/or my child participate and/or at my/our own risk. I represent that I am the parent or legal guardian of said child and have the lawful authority to enter into this Release on his or her behalf, and understand that Anchor Sports, LLC is relying upon said representation to its potential detriment. In consideration of the agreement of Anchor Sports, LLC, its owners, officers, trustees, attorneys, representatives, beneficiaries, employees, agents, members, sponsors, promoters and affiliates (hereinafter “Releasees”) allowing me or my child/children to participate and/or watch the above referenced voluntary sport, event or activity, hereby on behalf of myself, my minor child, my heirs, assigns and personal representatives (hereinafter “Releasors”), we release and forever discharge Releasees from any and all liability, claims, lawsuits, losses, damages, injuries, including but not limited to serious bodily injury and death, costs, legal fees, and/or expenses associated with my use of the facilities and/or participation in any event at the facilities, whether as a participant or a spectator. Releasors waive their right to any such claim to the extent permitted by law. I further covenant and promise to hold Releasees harmless against all such claims and to defend and indemnify the Releasees. Said duty to defend shall include all costs, expenses, legal fees, and any other monies paid on account of such claims and shall vest and be owed upon the utterance of such a claim. Said duty to defend shall not be contingent upon the merits of the claims or findings of fact, but shall accrue upon the mere utterance of such claims. Said duty to defend shall not be effected in any way by the concomitant utterance of additional claims, whether mandatory or permissive, and the Releasors agree to defend the Releasees against the entire claim or lawsuit the moment it is uttered, either verbally or in writing. This Release shall include any such claims against any such person or organization arising directly or indirectly from, or attributable in any legal and/or factual way to any negligence, action or omission to act of Releasees and/or of any such person or 2 organization in connection with sponsorship, organization or execution of any sporting event or activity in which I may participate as a team member or spectator. I fully realize the dangers of participating in the event or activity referred to above and fully assume the risks associated with such participation, whether as an active participant or a spectator, including, by way of example, and not limitation, the following: the dangers of collisions with other players; fixed or moving objects; the dangers arising from surface hazards; equipment failure; a lack of safety equipment; and inadequate safety equipment. This shall include the risk of serious physical and/or mental trauma, injury, and/or death. I hereby waive, release, and discharge for myself, my heirs, executors, administrators, legal representatives, assigns, and successors in interest (hereinafter collectively “successors”) and all rights and claims which I have or which may hereafter occur to me against Anchor Sports, LLC, the sponsor of this event, any promoters and any promoting organization(s), property owners, law enforcement agencies, and all public entities through or by which the events will be held for any and all damages which may be sustained by me directly or indirectly in connection with, or arising out of, my participation in or association with the event, inclusive of travel to or from the event. I agree, for myself and successors, that the above representatives are contractually binding and are not mere recitals, and that should I or my successors assert my claim in contravention of this agreement, Releasors shall be liable for the expenses incurred (including but not limited to legal fees) incurred by the other party or parties in defending the claims. The parties agree that this Release shall be governed by Rhode Island law. Anchor Sports, LLC, reserves the right to cancel any program if sufficient enrollment is not met and a full refund would be made, otherwise, there are no refunds. I agree to conduct myself in a sportsperson like and socially responsible manner. I understand that my failure to do so, solely in the opinion of Anchor Sports, LLC, may result in suspension or expulsion from the league/program without refund. I also understand that my registration is non-transferable.
*
I have read the above statement.
Print Name of Parent/Guardian (Please include date)
Signature
*
Clear Signature
Submit