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In consideration of _________________________, my minor child/ward.  (I/my child), being allowed to participate in any way in the track and field program, related events and activities.


The undersigned acknowledge, appreciates, and agrees that:


  1. The risk of injury to my child from activities involved in these programs is significant, including the potential for permanent disability and death, and while particular rules, equipment, and personal discipline may reduce the risk, the risk of serious injury does exist; and,
  2. FOR MYSELF, SPOUSE, AND CHILD, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE negligence OF THE RELEASES or others, and assume full responsibility for my child’s participation; and,
  3. I willingly agree to comply with the program’s stated and customary terms and conditions for participation.  If I observe any unusual significant concern in my child’s readiness for participation and/or in the program itself, I will remove my child from participation and bring such attention of the nearest official immediately; and,
  4. I, myself, my spouse, my child, and on behalf f my/our heirs, assigns, personal representatives and next of kin, HEREBY RELEASE THE other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event (“Releases”),  WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person to property incident to my child’s involvement or participation in these programs, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASES OR OTHERWISE, to the fullest extent permitted by law.
  5. I, for myself, my spouse, my child, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY IDEMNIFY AND HOLD HARMLESS all liabilities incident to my involvement or participation in the programs, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent permitted by law.



In consideration of _____________________________, my minor child/ward

being allowed to participation in any way in the Elite Champions Track Club program, related events and activities, the undersigned agrees that such

participants likeness may be photographed or videotaped and that such image

may be published in our outlet used to promote or publicized the sports program.




I have read and discussed with my child the code/rules of conduct and the athletes’/parents’ responsibility.


I agree to allow my child to participate as part of the Elite Champions Track

Club, abiding by all the code and rules of conduct.


I understand that I may withdraw my permission for my participation at any





I have read the release of liability and assumption of risk agreement, fully understand its terms, understand that I have given up substantial rights by

signing  it, and sign it freely and voluntarily without and inducement.


__________________________________   ________________________________

(Parent/Guardian Signature) (Print Name)






I understand that seriousness of the risk involved in participating in this program,

my personal responsibilities for adhering to rules and regulations, and accept them

as a participant.


___________________________________   ________________________________

(Participant’s Signature) (Print Name)





If you have any questions, please contact team Coach Reggie Smith at 704-900-4372 or Coach AJ at 336-451-0370 or contact us at http://www.charlottepantherstrackclub.com