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 I hereby attest that I am fully aware of the risks involved in the sport of adult kickball ("Kickball") and voluntarily assume the same, and agree to abide by the published kickball rules of WARWICK ADULT KICKBALL LEAGUE at all times during my participation in Kickball. I further attest that I do not suffer from any heart, lung or other medical condition or disease that might in any way hinder or prevent me from fully participating in Kickball or make me more susceptible to injury or harm while playing Kickball. In consideration of received permission to participate in Kickball: (A) I hereby release, discharge and hold harmless WARWICK ADULT KICKBALL LEAGUE and its officers, directors, employees, members, subsidiaries, agents, successors, managers, volunteers, assigns, and any party named as an additional insured on any policy of insurance held by any of the foregoing parties, or other parties which WARWICK ADULT KICKBALL LEAGUE has or may be obligated to indemnify, hold harmless or to which WARWICK ADULT KICKBALL LEAGUE may otherwise be liable, including but not limited to all governmental or private entities which lease, rent or permit use of premises for play, recreation, pre or post game activities (collectively, the "Released Parties"), from any and all liability that may arise directly or indirectly at any time, by reason of any injury, death, damage, loss, or expense incurred in connection with (i) my participation in the sport of Kickball itself, or (ii) my attendance at any social or charitable event or gathering that may be organized, authorized, or paid for by the Released Parties, individual Kickball players, or any league or division organized under the Released Parties or their rules, including but not limited to "happy hours", bar functions, and any pre-game or post-game events or gatherings; and (B) I fully authorize WARWICK ADULT KICKBALL LEAGUE, its subsidiaries and affiliates to use my name, likeness or image for purposes of advertising, marketing, promotion or trade without further compensation, except where prohibited by law; and I further acknowledge and agree that any images or recordings obtained or procured by WARWICK ADULT KICKBALL LEAGUE shall be the sole and exclusive property of WARWICK ADULT KICKBALL LEAGUE, and may be published, broadcast or otherwise disseminated at the sole and exclusive discretion of WARWICK ADULT KICKBALL LEAGUE. This Player Release Waiver shall be binding on my heirs, executors, administrators, successors, and assigns, and the releases and waivers contained herein shall include damages, losses or injuries that may be caused solely or in part by the fault (including but not limited to negligence, gross negligence and/or recklessness) of the Released Parties.

[This document must be accepted at time of registration]