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In case of an emergency, if I (the parent/guardian), or my family physician cannot be reached, I authorize my minor child/ward to be treated by paramedics, emergency room physicians, or physicians or medical personnel.

REFUND/CANCELLATION POLICY: I understand that my entire fee is non-refundable. I further understand there will be no refund or credit for tryouts, practices, games or camp sessions unattended by Participant. The Illinois BLAZE reserves the right to cancel any practice or game or decline any application. Permission is given to use my child’s photo or endorsement for promotion. WAIVER AND GENERAL RELEASE AND COVENANT NOT TO SUE: As parent or legal guardian for the above named participant (the "Participant") I hereby give my consent to Participant’s participation in the program to be held by the Illinois BLAZE. I acknowledge that participation in the program involves the risk of personal injury to Participant or others. Understanding that risk and in consideration of Participant being allowed to participate in the Program, I, on my own behalf and on behalf of Participant, Participant’s heirs, administrators, executors, and assigns, hereby (i) fully release and discharge the Illinois BLAZE and all of its respective officers, agents, employees, shareholders, and partners and representatives, and any and all of their respective subsidiaries or affiliates (the “Releasees”) from any and all claims, demands, liabilities, or causes of action of whatsoever kind or nature, in longevity or otherwise, which hereinafter may accrue against them and which in any way arise as a result of Participant’s participation in the Program, regardless of whether based on fault or negligence of the Releasees, (ii) covenant not to sue any of the Releasees for any matter relating to Participant’s participation in the Program, and (iii) indemnify, defend, and hold Releasees harmless from and against any and all losses, damages, costs or expenses (including attorneys’ fees and other costs of defense) which any of them may sustain as a result of, or in connection with, Participant’s participation in the Program. I have read this Waiver and General Release and Covenant Not to Sue and Refund/Cancellation Policy carefully and fully understand the contents. I am aware that this is an agreement not to sue the Releasees and constitutes a complete release of liability by me and by Participant in favor of the Releasees. I acknowledge that I am signing this document of my own free will, with full knowledge of the risks being assumed which include, without limitation, the risk of injury or death to Participant regardless of how it arises and even if it results from the negligence or fault of the Releasees.