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OTA Consent & Release

OZARK TENNIS ACADEMY, LLC CONSENT, ACKNOWLEDGMENT AND RELEASE

I, the undersigned Parent/Guardian, provide this Consent, Acknowledgment and Release to Ozark Tennis Academy, LLC (“OTA”) freely, voluntarily, and without duress, and intend for it to be effective immediately, on the following terms:

CONSENT, GENERAL RELEASE, INDEMNIFICATION AND HOLD HARMLESS: I acknowledge the risks involved in athletic participation, including any tennis program or event (including practice) recognized, sanctioned, sponsored or conducted by OTA (collectively, an “OTA Event”), and acknowledge that such activities (including travel thereto) have inherent dangers that no amount of care, caution, instruction or expertise can eliminate. I acknowledge that the requirements, directions and standards set by OTA are established for my child’s benefit. I understand that serious injury, and even death, is possible in such participation and choose to accept any and all responsibility for his/her safety and welfare while participating in an OTA Event and related transportation. With a full understanding of the risks involved, I hereby give Consent for my child to participate in all OTA Events, including all related transportation. I hereby release and hold harmless OTA, its officers, members, employees, instructors, volunteers, agents, independent contractors, and/or others acting on its behalf, and the Bentonville School District, its officers, employees, instructors, volunteers, and/or others acting on its behalf (collectively, the “Released Parties”) from any and all responsibility and liability for any injury or claim resulting from athletic participation in an OTA Event or any travel associated therewith, and agree to take no action against the Released Parties because of any accident or mishap involving my child. I further expressly understand and agree that the foregoing is intended to be as broad and inclusive as permitted by the law of the State of Arkansas and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full force and effect.

MEDICAL RELEASE: I hereby indicate that my child has no medical condition that will prevent him/her from participating in an OTA Event. I authorize emergency medical treatment for my child should the need arise for such treatment while my child is under the supervision of OTA. I further hereby authorize the use or disclosure of my child’s health information should treatment for illness or injury become necessary.

INSURANCE: My child is covered by our family health insurance plan. I acknowledge that OTA does not carry insurance to cover injuries and losses that may occur during an OTA Event or during my child’s travel to, from and during an OTA Event.

PHOTOGRAPHIC RELEASE: I grant the Released Parties the right to photograph and/or videotape my child and further to use my child’s name, face, likeness, voice and appearance in connection with exhibitions, publicity, advertising, promotional and commercial materials without reservation or limitation. The Released Parties, however, are under no obligation to exercise such rights.

HAVING READ, UNDERSTOOD, AGREED WITH, AND ACCEPTED THESE TERMS, I HAVE EXECUTED THIS DOCUMENT, TO BE EFFECTIVE IMMEDIATELY.

Children’s Names:

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Name of Parent/Guardian (printed)

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Signature of Parent/Guardian

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Date

Cell Phone number _______________