Consent & Waiver Form
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Consent
to Publication.
I hereby give USTA Tennessee and their representatives the irrevocable
right to use my name, picture, photograph, or other likeness in all forms and media,
and in all manners. This includes but is not limited to print and the web. I
waive the right to inspect or approve the finished version (s), including any
written copy that may accompany it.
Print Child’s
Name:______________________________________________________________________
Signature:___________________________________________________Date:
_____________________
(Parent or
Guardian)
Medical Release: I hereby consent to emergency first aid and other medical procedures, or
hospital service that may be rendered by or at accredited hospitals, by
appointed physicians, which at the time of injury or illness seem reasonably
advisable. I further understand that I will be
responsible for payment of any such medical procedures.
Print Child’s
Name:______________________________________________________________________
Signature:___________________________________________________Date:
_____________________
(Parent or
Guardian)
Waiver
and Indemnity Agreement: In
consideration of my participation in these tennis activities, I the
undersigned, agree to be legally bound, hereby, for myself, my heirs, executors
and administrators, waive and release any and all rights and claims for damages
I may have against the United States Tennis Association (USTA), the host
facility and any and all sponsors and their representatives, successors, and
assigns for any and all injuries suffered by me in said event. I have read and understand the foregoing releases, waivers and indemnity
agreement.
Print Child’s
Name:______________________________________________________________________
Signature:___________________________________________________Date:
_____________________
(Parent or
Guardian)
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