The undersigned, (parent/guardian name) consent to my child (child’s name) participating in boxing-related activities, including, without limitation, weight-training, cardiovascular-training, general boxing-training and sparring (the “Activities”) conducted and/or to be conducted at Haverhill Inner City Boxing Club, Inc., Haverhill, Massachusetts (“Haverhill Inner City Boxing Club”). I promise and represent that the information about my child at the bottom of this Waiver and Release is true, complete and correct.

In consideration of, and in order to induce the operator(s) of Haverhill Inner City Boxing Club to allow my child the opportunity to participate in the Activities, the receipt and sufficiency of which consideration I hereby acknowledge, and knowingly and voluntarily and intending to be legally bound:

I promise and represent that: (1) my child is physically able to fully participate in the Activities; (2) I fully comprehend, accept and assume all of the risks associated with my child’s participation in the Activities; (3) I understand that while the staff is trained in safety and my child will be fitted for protective gear, boxing is a contact sport and injuries, sometimes serious in nature, happen despite best efforts to guard against them; (4) my child suffers from no physical injury, illness, condition, impairment and/or disability (whether or not minor or serious) that would make him/her susceptible to injury and/or disability in performing any activity contemplated by the Activities.

I, for myself and for and on behalf of my heirs, personal representatives, administrators, successors and assigns, hereby irrevocably forever discharge and release Haverhill Inner City Boxing Club; all persons and entities comprising and/or associated with Haverhill Inner City Boxing Club; all persons who participate in organizing, managing, directing, conducting and/or operating the Activities at Haverhill Inner City Boxing Club; the Haverhill Inner City Boxing Club facility and its owners, operators and representatives; and any and all persons representing Haverhill Inner City Boxing Club (collectively, the “Releasees”), jointly and severally, of and from any and all liabilities, claims, demands, costs, expenses, damages, actions and/or causes of action (including, without limitation, any claim based on negligence or misconduct of any kind), to the maximum extent permissible by law, that I or my child have and/or may incur or acquire during the course and/or as a result of my child’s participation in and/or involvement with the Activities at Haverhill Inner City Boxing Club.

I understand that Haverhill Inner City Boxing Club is a nonprofit corporation and therefore, in addition to and independent of my signing this waiver and release, certain limitations on corporate and/or individual liability may apply.

I agree and acknowledge that I am executing this Waiver and Release with the understanding that my child is participating in these Activities for the purpose of training, learning, exercising, and/or participating in other activities relating to boxing at Haverhill Inner City Boxing Club. I authorize any person who conducts the Activities to release all information relating to my child’s participation in the Activities at Haverhill Inner City Boxing Club.

I agree and acknowledge that I am executing this Waiver and Release with the understanding that it in no way constitutes a contract or an offer of employment between me or my child and Haverhill Inner City Boxing Club or any other person or entity.

In consideration of the opportunity for my child to participate in the Activities, and in recognition of the need for Haverhill Inner City Boxing Club, as a nonprofit corporation, to solicit donations, raise funds, and market its services, I further authorize and grant to Haverhill Inner City Boxing Club, any right and permission to use, copyright, publish and re-publish my child’s image, likeness, appearance and voice in the forms of photograph, video, sound-clip, interview or any other form, in the same, in whole or in part, in conjunction to any matter related to Haverhill Inner City Boxing Club and for any purpose whatsoever. I understand that my child’s image, likeness, appearance and voice may be used for illustration, promotion and advertising or for any other purpose. I further grant to Haverhill Inner City Boxing Club the right to produce or reproduce my child’s image, likeness, appearance and voice on television, radio, satellite, internet, print or any other form of media. I hereby also grant to Haverhill Inner City Boxing Club the right to transfer, use or cause to be used, my child’s image, likeness, appearance and voice. Neither have I otherwise been compensated nor will I seek at any time compensation for any such use of my child’s image, likeness, performance, appearance and/or voice by Haverhill Inner City Boxing Club. I understand that all photographs, videos, sound-clips, interviews or any other form of media (including electronic media whether now known or hereafter created) taken of my child is and will be the sole property of Haverhill Inner City Boxing Club. I irrevocably release and discharge Haverhill Inner City Boxing Club from any claims of invasion of privacy and/or right to publicity and/or copyright infringement and/or any intellectual property rights claim of any kind whatsoever.

I understand that in the event of injury or illness to my child, Haverhill Inner City Boxing Club will attempt to contact me at the emergency contact number listed below. In the event I cannot be reached, I hereby authorize Haverhill Inner City Boxing Club to seek medical care for my child and to make decisions relating to my child’s emergency medical care until I can be reached.

I have read the foregoing and fully understand and agree to the contents thereof. This Waiver and Release shall be binding upon execution. If I do not execute this Waiver and Release by signing it, my allowing my child to participate in the Activities shall conclusively be deemed my understanding and agreement to the terms of this Waiver and Release. I agree that if any dispute arises as to the scope, effect, meaning, interpretation or anything else relating to this Waiver and Release and/or any injury and/or its consequences, such dispute will be decided by a judge and any trial on any issue relating to or arising out of this Waiver and Release will be without a jury.