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P.O. Box 45736
Madison, WI 53744
Dairyland Sports is a 501(c)3 non-profit organization. Founded in 2017, Dairyland Sports aims to engage and empower individuals with physical disabilities to improve their health and well-being through participation in sport, fitness, & recreation. EIN: 82-3718737
In consideration of my and/or my child’s participation in the Dairyland Sports Corporation (“Dairyland Sports”) programming, I, the undersigned, for myself, and/or my child, our heirs, executors, administrators and assigns, hereby waive and release any and all claims for damages, personal injury or death, or loss of property I and/or my child may have or that may subsequently accrue to me, my child, or to our heirs, executors, administrators or assigns. Further, I the undersigned, and/or my child discharge and release in advance Dairyland Sports, program or event sponsors, organizers, promoters, volunteers, and other appropriate committees/boards, representatives, successors and assigns from any and all liability arising out of or connected in any way with mine and/or my child’s participation in Dairyland Sports programming, even though that liability may arise out of negligence or carelessness on the part of the persons or entities mentioned above.
I and/or my child voluntarily assume all risks of loss, damage, injury, or death that may be sustained while participating in Dairyland Sports programming. I and/or my child attest and verify that I am physically fit, as determined by licensed medical provider, to participate in physical activity and sports, and acknowledge that I am aware of the inherent risks in participating in any physical activity and sports. In case of illness or accident, I grant permission for medical treatment to be administered by on-site medical staff as designated by Dairyland Sports. I and/or my child understand and agree that medical or other services rendered to me and/or my child by, or at the instance of, any of the persons or entities mentioned above is not an admission of liability to provide or continue to provide any such services and is not a waiver by any of the persons or entities mentioned above of any right hereunder.
I and/or my child further understand that serious accidents occasionally occur during physical activity and sport, and participants in such events occasionally sustain personal injury and/or property damages as consequences thereof. Knowing of such inherent risks, I and/or my child nevertheless hereby agree to assume those risks and to release all of the persons and entities mentioned above, who through negligence, carelessness or otherwise, might be liable to me and/or my child. I agree to accept and abide by the rules and regulations set forth by Dairyland Sports, and to obey the directions of the designated officials for my own safety and the safety of others.
As a condition of my participation in Dairyland Sports Corporation (“Dairyland Sports”) programming, I hereby grant Dairyland Sports the irrevocable right and permission to use my name, likeness, image, photograph, voice, video, athletic performance, biographical and other information (collectively, “Likeness”), on Dairyland Sports website and in any media platform or publications, promotional flyers, educational materials, derivative works, or for any other similar purpose without compensation to me. Additionally, I understand and give consent for Dairyland Sports permission to negotiate with third parties to utilize my Likeness in promotional and/or fundraising events for charitable purposes.
I understand and agree that such photographs, video recordings, or other Likeness may be placed on the Internet and social media platforms. I also understand and agree that I may be identified by name and/or title in printed, Internet, or broadcast information that might accompany the photographs and/or video recordings of me. I waive the right to approve the final product and agree that all such portraits, pictures, photographs, video and audio recordings, and any reproductions thereof are and shall remain the property of Dairyland Sports.
I hereby release, acquit, and forever discharge Dairyland Sports and its current and former trustees, agents, officers, directors, and employees from any and all claims, demands, rights, promises, damages and liabilities arising out of or in connection with the use or distribution of my Likeness, including but not limited to any claims for invasion of privacy, appropriation of Likeness or defamation.
I warrant that I am eighteen (18) years old or more and competent to contract in my own name or, if less than eighteen years old, that my legal guardian has signed this release form. This release is binding on me and my heirs, assigns, and personal representatives.