TO: Houston Volleyball Academy

FROM: 2001-02 HVA Player’s & Parents

SUBJECT: Hold Harmless Agreement

I acknowledge that volleyball or any sporting event is an extreme test of a person’s physical and mental limits and that my participation in a volleyball event can cause potential death, serious injury, or property damage. With a full understanding of the potential risks, I HEREBY ASSUME THE RISKS OF PARTICIPATING OR OFFICIATING IN A VOLLEYBALL EVENT.

I hereby take the following action for myself, my executors, administrators, heirs, next of kin, successors and assigns: a) I WAIVE, RELEASE, AND DISCHARGE from any and all claims or liabilities for death or personal injury or damages of any kind, EXCEPT THAT WHICH IS THE RESULT OF GROSS NEGLIGENCE AND/OR WANTON MISCONDUCT OF PERSONS OR ENTITIES LISTED BELOW, which arise out of or relate to my traveling to and from or my participation in any volleyball event, THE FOLLOWING PERSONS OR ENTITIES: Houston Volleyball Academy, sponsors, and the officers, directors, coaches, representatives, and agents of any of the above; b) I AGREE NOT TO SUE any of the persons or entities listed above for any of the claims or liabilities that I have waived, released or discharged herein; and c) I INDEMNIFY AND HOLD HARMLESS the persons or entities mentioned above from any claims made or liabilities assessed against them as a result of my actions.

_________________

PRINT-Player Name

_________________ _____________________ ____________

PRINT-Parent Name SIGN- Parent Signature Date

STATE OF )

)

COUNTY OF )

SWORN TO BEFORE ME, a Notary Public, by said _____ personally

known to me this day of , 20 _____.

Notary Public

My Commission Expires