The Champion's Edge: BLIZZARD BASEBALL CONFIDENCE AND PERFORMANCE CLINIC Guardian Name * First Name Last Name Phone * (###) ### #### (Guardian) Email * Athlete's Name * First Name Last Name Name of Team * TALENT - PARTICIPATION RELEASE * RELEASE - CHILD I grant permission to Championship Culture Coach and its agents to use my minor child’s image (whether still, motion picture or video), recordings of my voice, and my name in association with the purpose(s) designated above. I further agree to permit editing of the production medium (digital file, video, film or audio recording) to the extent necessary for normal production purposes, provided that the intent of my performance is not altered. I understand that I/we will not be compensated for this participation. YES NO Type Guardian Name * WAIVER & RELEASE OF LIABILITY * Disclaimer: Championship Culture Coach LLC, Becky Beaulieu, nor their employees, nor sub-contractors are responsible for any injury or loss of property to any person while practicing, taking class, private lesson, competing, or involved in any other way in athletic activity, mental edge lessons, or culture consultation. The parties listed above are not responsible for a loss, nor financial loss that follows culture consultation, coaching, or mental edge lessons. In consideration of my participation, I hereby release and covenant not-to-sue Championship Culture Coach LLC, Becky Beaulieu, nor its agents or sub-contractors from any and all present and future claims resulting from ordinary negligence on the part of Championship Culture Coach LLC or others listed for property damage, personal injury, or wrongful death, arising as a result of my engaging in or receiving instruction in athletic related activity, mental edge lesson, culture consultation, or any other activities incidental thereto, wherever, whenever, or however the same may occur. I herby voluntarily waive any and all claims resulting from ordinary negligence, both present and future, that may be made by me, my family, team, estate, heirs, or assigns. Further, I am aware that mental edge sessions, culture consultation, private lessons, and/or athletic activities are vigorous mental or sporting activities that pose a risk of injury. I understand that athletic related activities such as those listed above include risks, including but not limited to death, serious neck and spinal injuries resulting in complete or partial paralysis, brain damage, and serious injury to virtually all bones, joints, muscles, and internal organs. I understand that the coach and equipment provided may be inadequate to prevent serious injury. The risk of harm may be limited by all of the safety equipment and trained coaches, but never eliminated. I understand that participation in athletics and related activities involves activities incidental to active participation which may leave me vulnerable to the reckless actions of other participants who may not have complete control over their actions or who may not see the other students in the gym, court, or field. I am voluntarily participating in this activity with knowledge of the risks of property damage, personal injury, financial loss, or death. I further agree to indemnify and hold harmless Championship Culture Coach LLC and all others listed for any and all claims arising as a result of my engaging in or receiving instruction, coaching, consulting, or any activities incidental thereto, whenever, wherever, or however the same may occur. I understand that this waiver is intended to be as broad and as inclusive as permitted by the laws of the state of Wisconsin and whichever state the instruction occurred. I agree that if any portion is held invalid, the remainder of the waiver will continue in full legal force and effect. I further agree that the venue for any legal proceeding shall be within the state of Wisconsin. I affirm that I am of legal age and am freely signing this agreement. I have read this form and fully understand that by signing this form, I am giving up legal rights and or remedies which may be available to me for the ordinary negligence of Championship Culture Coach LLC, Becky Beaulieu, or any person listed above. YES NO Type Guaridan Name * BLIZZARD BASEBALL WAIVER * I hereby give consent for my son to participate in all games, activities and trips sponsored by Competitive Edge Solutions Network, Inc., also doing business Minnesota Baseball Academy, Minnesota Blizzard, USSSA, Minnesota Prospects, Advanced Fall Baseball League (AFBL) and/or ScoutStop (hereinafter MBA) I grant permission to MBA to enter player information including photo and photo likeness on a team website or social media if they choose. I understand that out-of-town travel by car, airplane or other means of transportation may be required, as well as overnight lodging in another city or state. Furthermore, I acknowledge that some of these expenses are not included in MBA registration or team fees. In consideration of MBA allowing my son to participate in its athletic program, I, the undersigned parent (or legal guardian) of my child, do hereby agree to indemnify and hold harmless the MBA, or its representatives (coaches, assistant coaches, parents providing transportation or serving as chaperones and persons in other localities providing lodging for overnight trips) for any injury or illness obtained by my child during any team activity, game, or transportation thereto. I further release, discharge and agree not to sue MBA or its representatives. I hereby request and grant permission to managers, coaches, assistant coaches, other officials and chaperones designated by MBA to obtain reasonable medical care for my child named above in the event of injury or illness during any team activity if a parent or legal guardian is not present. Such care may include, but shall not be limited to, first aid treatment, transportation to a medical facility and authorization for a physician to perform treatment as recommended by the physician. (Parents will be notified in case of serious illness or injury as quickly as possible. This release makes immediate treatment possible.) I understand that athletic activities at Minnesota Baseball Academy, other practice facilities and on the baseball field involve risks and dangers of serious bodily injury. As the parent or guardian, I fully accept these risks, and assume such risks and all responsibility for losses, costs, and damages I incur or my child incurs as a result of his participation in any MBA activity. In consideration of being permitted to participate in the activities of the MBA in any manner, including but not limited to playing, practicing, coaching, spectating or being on the field or in spectator areas for any purpose whatsoever, and fully understanding that participation in the game of baseball includes the risk of serious personal injury, I fully and absolutely assume responsibility for the risk of injury due to participation, weather conditions, playing conditions (including the type of bases, plates, fences, and equipment) other participants, of any magnitude including fatality, and does hereby forever absolutely release, even for their own negligence, and agrees to hold harmless MBA all government bodies and landowners that may sanction or permit the participation in the game of baseball; all employees, other participants, agents, servants, officers, public officials, volunteers, game officials and sponsors from all claims for damage whatsoever of any kind now or in the future. YES NO Type Guardian Name * Type Athlete Name * Date MM DD YYYY Thank you! If you are not re-directed in 5 seconds, click here