2010 TEAM GEORGIA WEIGHTLIFTING
THE OPEN CHAMPIONSHIP
OFFICIAL ENTRY FORM
Please enter me
in the 2010 Team Georgia Weightlifting The Open
Championship to be held on March 13, 2010 at Flowery Branch High
School.
I certify that I am an amateur in good standing. In consideration of
my entry in the competition, I do hereby waive, and release USA
Weightlifting and Team Georgia Weightlifting, their respective
directors, officers, officials, agents and competition personnel,
hereinafter known as the "Organizers," from any and all causes of
action, loss, liability, claims and demands of every kind and
nature, which I or my heirs or personal representatives may have for
bodily injury, for expenses of medical treatment, hospitalization,
and other care rendered to me in the
event of my injury or illness, or for any and all other costs,
damages or loses suffered or incurred by me or occasioned to me in
connection with my travel to and from, and my participation in, the
competition and related activities, except that the forgoing waiver
and release shall not apply to injuries, damages, and losses
resulting from the gross negligence and/or wanton misconduct of the
Organizers or to bodily injuries and medical expenses covered by
accidental death, dismemberment and/or loss of sight and medical
reimbursement insurance policies maintained by the Organizers.
I agree to be filmed and photographed under conditions approved and
authorized by the USA Weightlifting, to include the use of my name,
biographical information, public appearances, interviews,
photographs, portrait and motion pictures and television recordings
of my weightlifting performance and grant to USA Weightlifting and
Organizers the right to record and make use of the same, and to
authorize others to do so in promoting the competition and the
success of the weightlifting team on which I compete, to promote the
image of USA Weightlifting, its sponsors and advertisers, and the
sport of amateur weightlifting, and to fund the activities of the
USA Weightlifting.
I (and my parent or guardian, if I am a minor), agree that the
Organizers and its agents, including competition personnel, may make
judgments (with appropriate input from available medical personnel),
as to my treatment, hospitalization or other medical care in the
event of my illness or accidental injury in connection with my
participation in the competition, should I be disabled or
incompetent to make necessary and appropriate decisions concerning
such treatment, hospitalization or other care. I authorize the
Organizers, its agents and competition personnel to make such
decisions for me as though they stood in a relationship to me of
parent, guardian or next of kin should circumstances require the
Organizers, its agents and competition personnel to make such
judgments, and my next of kin cannot be timely and conveniently
contacted to participate in the making of such judgments.
I hereby release and agree to hold the Organizers, its agents and
competition personnel harmless from all expenses, causes of action,
liability, claims and demands arising from good faith judgments made
by the Organizers, its agents and competition personnel concerning
my treatment, hospitalization and medical care in the event of my
illness, injury or other emergent circumstances in connection with
the competition.
I (and my parent or guardian, if I am a minor), agree that I will be financially responsible for treatment, hospitalization and other medical care rendered to me in the event of my illness, injury or other emergency circumstances in connection with the competition, except to the extent my injuries and medical expenses, if any, are covered by accidental death, dismemberment and/or loss of sight and medical reimbursement insurance policies maintained by the Organizers for my benefit, in which event I will nevertheless continue to be financially responsible for expenses of treatment, hospitalization and other medical care in excess of such policies' limits.
BY CLICKING "I AGREE" BELOW, YOU ACKNOWLEDGE THE CONDITIONS SET ABOVE AND ACCEPT THIS AS YOUR DIGITAL SIGNATURE.