NEW YORK ATHLETIC CLUB
JUNIOR SQUASH CLINIC AT THE CITY HOUSE
CONSENT AND RELEASE AGREEMENT

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Date of Birth*
1. I am the Parent (or Guardian) of the child named above.

2. I consent to and give permission for the child’s participation in the New York Athletic Club Junior Squash Clinic (the “Junior Squash Clinic”) sponsored by the New York Athletic Club of the City of New York, Inc. (NYAC) at its facilities at 180 Central Park Ave. South, New York, New York 10019.

3. I understand and acknowledge that the Clinic and its facilities and equipment are for instructional and not recreational or amusement purposes.

4. I understand and acknowledge that the sports and related activities involve some inherent risks of injury, including serious injury, to its participants, that I have evaluated and appreciate the nature of such risks, and they are voluntarily assumed.

5. I understand and acknowledge that sports and related activities can require strenuous physical activity and exertion. My child has received regular medical examinations and is in good health and I am not aware of any physical or medical condition that would restrict my child from participating in this Clinic. If I should become aware of any such condition, I will inform you and will not permit my child to attend the Clinic while such condition exists.

6. I, on behalf of myself, the child and any other parent or guardian, release, discharge and covenant not to sue on account of any claims of liability caused by or resulting from the passive or active negligence on the part of the NYAC, to the fullest extent permitted by law, relating to my child’s participation in the Clinic. If any portion of this agreement and release shall be held to be invalid, then the remaining portion shall continue in full force and effect. This release is intended for the benefit of the NYAC and its officers and governors, members, employees, staff, instructors, agents, volunteers and affiliates.

7. This agreement and release shall be governed by the laws of the State of New York.

8. I acknowledge that I have read and understand this agreement and release, that I am signing and entering into this agreement voluntarily and in consideration of my child’s participation in the Clinic and that I have not relied on any representation that is not specifically set forth above in entering into this agreement and release.

9. I give permission for my child’s likeness to be used in social media or marketing materials used by the NYAC.
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Date*