Nazareth University / Upstate Speed Elite, Speed Clinic Acknowledgement of Assumption of Risk and Release/Waiver of Liability

PLEASE READ THIS DOCUMENT CAREFULLY BEFORE SIGNING. ITS EFFECT IS TO RELEASE NAZARETH UNIVERSITY FROM ANY LIABILITY RESULTING FROM YOUR PARTICIPATION IN THE ACTIVITY AND TO WAIVE CLAIMS AGAINST NAZARETH UNIVERSITY FOR ANY POTENTIAL DAMAGES OR LOSSES RESULTING FROM YOUR PARTICIPATION IN THE ACTIVITY.

In consideration for being allowed to participate in Upstate Speed Elite, Speed Clinics at Nazareth University,
I, __________________________________________(participant’s name) acknowledge, understand, and appreciate that:
1. The Activity, and any and all related events and action including, but not limited to fundraisers and charity events, may
present various risks, some of which may be serious; and
2. These risks may include, but are not limited to, contusions, muscle strains and sprains, broken bones, lacerations, cardiac
malfunction, head, neck and back injury, concussions, permanent and temporary paralysis, drowning, death, and personal
property damage or loss; and
3. I choose to knowingly and voluntarily participate in the Activity with full knowledge that the Activity may be hazardous to
me and/or my personal property; and
4. I voluntarily assume full responsibility for any risk of injury, both known and unknown, which may be sustained by me as a
result of my participation in the Activity and which may be caused by my own actions, inactions, or negligence, as well as
from the actions, inactions, or negligence of others, including Nazareth, or the condition of the premises; and
5. I accept full responsibility for paying any medical or associated expenses that I may incur while participating in the Activity;
and
6. I certify that I have, and will maintain throughout my participation in the Activity, medical insurance; and
7. I hereby consent to first aid and emergency medical care for treatment for injuries that I may sustain while participating in
the Activity; and
8. I understand that I will be fully responsible for any expenses associated with the provision of care, including such care listed
in paragraph 7; and
9. I hereby expressly release, waive, and forever discharge Nazareth, Upstate Speed Elite and all representatives thereof from all
responsibility, claims, causes of action, damages, and liability whatsoever, in law or in equity, known or unknown, that might arise
out of my voluntary participation in the Activity. I also agree to indemnify and hold harmless Nazareth, Upstate Speed Elite and all
representatives thereof for any loss, liability, damage or costs, including court costs and attorneys’ fees, that may occur as a result of
my voluntary participation in the Activity. I acknowledge that my release, waiver, discharge, and agreement to indemnify and
hold harmless Nazareth, Upstate Speed Elite and all representatives thereof, is binding on myself, my family, my heirs, successors, and personal representatives; and
10. I understand that Nazareth and Upstate Speed Elite reserves the right to cancel, modify, or terminate the Activity if in its judgment, conditions so dictate.

I HAVE CAREFULLY READ THIS DOCUMENT AND HAVE HAD SUFFICIENT TIME TO SEEK EXPLANATION OF ITS PROVISIONS. AFTER CAREFUL CONSIDERATION, I SIGN THIS DOCUMENT VOLUNTARILY AND WITHOUT ANY INDUCEMENT AND AGREE TO THE ABOVE TERMS IN THEIR ENTIRETY.