Waiver

AGREEMENT, WAIVER AND RELEASE OF LIABILITY QCDEKHOCKEY, INC.

I, the undersigned participant, know that dekhockey is a potentially hazardous activity and I am choosing to participate in a dekhockey league sponsored by QCDekhockey, Inc. out of my own free will and choice.

In choosing to participate in a dekhockey league, I fully accept and assume all risk, whether before, during or after each dekhockey game and any events related to dekhockey activities. These include, without limitation, physical injury, mental injury, emotional distress, trauma, sickness, illness, death, contact with other participants, equipment failure, inadequate safety equipment, the effects of weather, and participating in other events at the dekhockey facility.

All risks are known and appreciated by me. I waive any and all specific notice of the existence of the risks including, but without limitation, the fact that all participants may not be supervised at all times. I shall assume and pay my own medical and emergency expenses in the event of injury, illness or other incapacity regardless of whether I authorized such expenses.

I realize that dekhockey, and its related events, requires physical conditioning and I represent that I am in sound medical condition capable of participating in dekhockey activities without risk to myself or others. I have no medical impediment which would endanger me or others. I understand and agree that a situation may arise during dekhockey activities which may be beyond the control of QCDekhockey, Inc. or others participating in any dekhockey events. I will participate in dekhockey within the limits of my own abilities and in a manner so as not to endanger either myself or others.

Knowing these facts, and in consideration of QCDekhockey, Inc. allowing me to participate in dekhockey, I for myself and anyone acting on my behalf, release, waive, discharge, covenant not to sue and agree to hold QCDekhockey, Inc. and its representatives, agents, employees and successors harmless from any and all claims, demands and actions of any and every kind I have, may have or may hereafter accrue against the released parties directly or indirectly arising out of or relating in any respect to my attending or participating in dekhockey activities and related events at any facility provided by QCDekhockey, Inc.

My waiver and release of all claims, demands, actions and liabilities shall include, without limitation, any injury, damage or loss to my person or property which may be: (a) caused by any act, or failure to act, by the above identified persons and entities or (b) sustained by me before, during or after dekhockey activities and related events.

I agree to abide by all rules and regulations set forth by QCDekhockey, Inc. I further agree to indemnify and hold the parties released above harmless from any and all losses, damages, claims and expenses, including attorney fees, arising from or relating in any respect to my participation in dekhockey activities or related events or my breach of this agreement.

IF I AM A MINOR, MY PARENT OR GUARDIAN ALSO IS SIGNING ON MY BEHALF AND WE BOTH AGREE TO BE BOUND BY THE TERMS OF THIS AGREEMENT, WAIVER AND RELEASE.

This is a Waiver and Release!
When you sign below, you are acknowledging that you have read this

Agreement, Waiver and Release in its entirety.

Participant Birth Date Address City State Zip Code Date Signed

Parent or Guardian, if Participant is under 18 Address (if different) City State Zip Code Date Signed