POLE VAULT WARNING AND WAIVER

Note: Warnings regarding lack of safety standards, inherent dangers and assumption of risks and the agreement to hold harmless need to be read and all instructions obeyed.

These forms release the Nevada Interscholastic Activities Association, its member schools, school officials, coaches and volunteers from liability.

Instructions of Students and Parent(s)/Legal Guardian(s): Please read both the student and the parent/legal guardian provisions of this Pole Vault Warning and Waiver and thereafter sign, date and return this form to the member school’s coaching staff. This form should be read and signed each year.

STUDENT-ATHLETE:

I am aware that practicing and competing in the pole vault can be a dangerous activity involving many significant risks of injury or death. I understand that the dangers and risks of practicing or competing in the pole vault include, but are not limited to, death, serious neck and spinal injuries which may result in complete or partial paralysis, brain damage, serious injury to virtually all organs, serious injury to virtually all bones, joints, ligaments, muscles, tendons and other aspects of the muscular skeletal system and serious injury or impairment of other aspects of my body, general health and well-being. I understand that the dangers and risks of practicing or competing in pole vault may result in serious impairment of my future abilities to earn a living, to engage in other business, social, and recreational activities and generally to enjoy life.

I acknowledge that pole vaulting manufacturers recommend various poles used in the pole vault be used by individuals meeting the recommended weight restrictions for that particular vaulting pole and that the marked limitations for hand holds for that particular vaulting pole and weight be observed at all times.

Due to inherent dangers of practicing and competing in the pole vault, I recognize the importance of following all recommended manufacturer’s recommendations and the instructions of the member school’s coaching staff concerning training and competing techniques, preparation and the use of the pole vaulting pit, practice or competition pursuant to supervision of the runway and pit areas, team rules and any other direction or instruction in regard thereto and I agree to fully, completely and timely observe and obey such recommendations, instructions and directions.

For and in consideration of the Nevada Interscholastic Activities Association and its member schools allowing me the privilege to practice and compete in the pole vault, I hereby agree to assume inherent dangers and risks associated with said practice and competition and agree to defend, indemnify and hold harmless the Nevada Interscholastic Activities Association and its member schools, school officials, coaches and volunteers from any liability, actions, causes of action, debts, claims or demands of any kind and nature whatsoever which may arise by or in connection with my participation in practicing and competing in the pole vault and I do hereby release said parties from such claim for injury and/or damages.

NIAA Pole Vaulting Waiver:

The terms set-forth hereinabove shall serve as a release and as an assumption of the risks for me, my heirs, estate, executors, administrators, assignees and for all other members of my family.

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Print Name of Student Athlete

_________________________________ _______________________________

Signature of the Student-Athlete Date

Note: This form must be signed (again) prior to each year of competition.

PARENT/LEGAL GUARDIAN:

I hereby affirm that I am the parent/legal guardian of the above-mentioned student-athlete. I hereby certify that I have read the student-athlete warnings, assumptions and release set forth hereinabove and understand its terms after having the opportunity to review the same with counsel of independent selection. I understand that all interscholastic sports practices and competitions can involve risk of death and substantial injury, including but not limited to those specific risks of death, substantial bodily injury, substantial impairment of economic future, social and recreational participation and general enjoyment of life set forth hereinabove in the STUDENT-ATHLETE section of this form.

For and in consideration of the Nevada Interscholastic Activities Association and its member schools permitting my child/legal ward to participate in pole vaulting practice and competition and to engage in all activities related to said participation, I hereby agree to defend, indemnify and hold harmless the Nevada Interscholastic Activities Association and its member schools, school officials, coaches and volunteers from any liability, actions, causes of action, debts, claims or demands of any kind or nature whatsoever which may arise by or in connection with my practicing or competing in pole-vaulting and I hereby release said parties from any such claim for injury and/or damage.

The terms set forth hereinabove shall serve as a release and as an assumption of the risks for me, my heirs, estate, executors, administrators, assignees and for all members of my family, including, but not limited to, the above-mentioned student-athlete.

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Print Name of Parent/Legal Guardian

_________________________________ _______________________________

Signature of Parent/Legal Guardian Date

Note: This form must be signed (again) prior to each year of competition.