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New to the gym?

1. Fill out this info sheet

2. SIGN THE Vaulting WAIVER Below

RELEASE OF LIABILITY AND HOLD HARMLESS AGREEMENT Mac Vault Academy and Coach Mac Memorial Sports Complex, LLC. 1. I, the undersigned, on behalf of my child, myself, my heirs and next of kin, personal representative, agents, insurers, successors and assigns agree to release and hold harmless Mac Vault Academy, Bradford and Deanna McFarling, Coach Mac Memorial Sports Academy, LLC., Pops Enterprises, LLC., its coaches, trainers, assistant coaches, volunteers, as well as the owners of the facilities and properties upon which any activity takes place (and said facilities agents, coaches, staff, personnel, agents and affiliates) from any present or future claim for physical or emotional injury, property damage or death arising directly or indirectly from my participation in the Program, to the fullest extent permitted under law, including allegations or claims of negligence on the part of any of the above-referenced parties; provided. 2. I further agree, for myself, my administrators, personal representatives, executors, predecessors, successors, agents, heirs and assigns not to sue, make or file any lawsuits, claims, proceedings or any other actions of any kind whatsoever against harmless Mac Vault Academy, Bradford and Deanna McFarling, Coach Mac Memorial Sports Academy, LLC., Pops Enterprises, LLC., its coaches, trainers, assistant coaches, personnel, volunteers, as well as the owners of the facilities and properties upon which any activity takes place (and said facilities agents, coaches, staff, personnel, agents and affiliates) for bodily injury, property damage, or death sustained during my participation in the program to the fullest extent permitted under law, including allegations or claims of negligence on the part of the above-referenced parties, provided, however, this Agreement does not apply to acts of gross negligence, willful conduct, or intentional conduct. I agree to indemnify, protect, defend, hold and save Mac Vault Academy, its coaches, trainers, assistant coaches, volunteers, as well as the owners of the facilities and properties upon which any activity takes place (and said facilities agents, coaches, volunteers, staff, personnel, agents and affiliates) harmless against and from any and all damages, losses, liabilities, obligations, penalties, claims or expenses, litigation, demands, defenses, judgments, suits, proceedings, costs, disbursements or expenses of any kind or of any nature whatsoever, incurred by or arising from or relating in any way to their child’s participation in The Program. 3. I hereby RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE Mac Vault Academy, Bradford and Deanna McFarling, Coach Mac Memorial Sports Academy, LLC., its coaches, trainers, assistant coaches, volunteers, as well as the owners of the facilities and properties, their officers, servants, agents, and employees (hereinafter referred to as RELEASEES) from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me, or to any property belonging to me, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES, or otherwise, while participating in such activity, or while in, on or upon the premises where the activity is being conducted or in transportation to and from said premises. 4. To the best of my knowledge, I/my child, can fully participate in this activity. I am fully aware of risks and hazards connected with the activity, including but not limited to the risks as noted herein, and I hereby elect to voluntarily participate in said activity, and to enter the above- named premises and engage in such activity knowing that the activity may be hazardous to me and my property. I VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISKS OF LOSS, PROPERTY DAMAGE OR PERSONAL INJURY, INCLUDING DEATH, THAT be sustained by me, or any loss or damage to property owned by me, as a result of being engaged in such an activity, WHETHER CAUSED BY THE NEGLIGENCE OF RELEASEES or otherwise. 5. I further hereby AGREE TO INDEMNIFY AND HOLD HARMLESS THE RELEASEES from any loss, liability, damage or costs, including court costs and attorney’s fees, that may incur due to my participation in said activity, WHETHER CAUSED BY NEGLIGENCE OF RELEASEES or otherwise. 6. It is my express intent that this Release and Hold Harmless Agreement shall bind the members of my family and spouse (if any), if I am alive, and my heirs, assigns and personal representative, if I am not alive, shall be deemed as a RELEASE, WAIVER, DISCHARGE AND COVENANT NOT TO SUE the above named RELEASEES. I hereby further agree that this Waiver of Liability and Hold Harmless Agreement shall be construed in accordance with the laws of the State of Texas. 7. I UNDERSTAND THAT Mac Vault Academy, Bradford and Deanna McFarling, Coach Mac Memorial Sports Academy, LLC., Pops Enterprises, LLC., WILL NOT BE RESPONSIBLE FOR ANY MEDICAL COSTS ASSOCIATED WITH AN INJURY I MAY SUSTAIN. 8.. The undersigned custodial/residential parent or legal guardian represents and warrants that he/she has the authority to sign on behalf of the Participant(s) to the terms of this Agreement. The undersigned has read and understands the above Agreement and understands the potential dangers involved in engaging in training of athletes in pole vaulting, speed training, weight training and any other athletic training of this program. The undersigned is fully aware of the legal consequences of the Agreement and agrees to its terms. 9. I also understand that I should and am urged by Mac Vault Academy to obtain adequate health and accident insurance to cover any personal injury to myself which may be sustained during the activity or the transportation to and from said activity, and to be a member of the USATF. IN SIGNING THIS RELEASE, I ACKNOWLEDGE AND REPRESENT THAT I have read the foregoing Waiver of Liability and Hold Harmless Agreement, understand it and sign it voluntarily as my own free act and deed; no oral representations, statements or inducements, apart from the foregoing written agreement, have been made; I am at least eighteen (18) years of age and fully competent; and I execute this Release for full, adequate and complete consideration fully intending to be bound by same. IN WITNESS WHEREOF, I have signed via the following information:

AGREE TO THE WAIVER

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