USAFL Medical Insurance Agreement and Rules Acknowledgment for Adults
- I, the undersigned (hereinafter, “I” or “Participant”), acknowledge that I am covered by a personal or group insurance policy that has $100,000 or more in coverage for medical, hospitalization, and other expenses of treatment and care should I be injured or become ill while or as a result of participating in any United States Australian Football League, Inc. (USAFL) related activities, including but not limited to warm-up, training, practice, games, clinics, travel, and social events (hereinafter referred to collectively as “Activities”) WITH NO RESTRICTION FOR ACCIDENTS OR ILLNESSES WHILE PARTICIPATING IN SPORTS, SPORTS-RELATED ACTIVITIES, OR RECREATIONAL ACTIVITIES. I understand such insurance will be my primary source of payment should medical treatment be necessary as a result of my participation in such Activities. The undersigned accepts full financial responsibility for and agrees to pay all costs of medical treatment or care incurred due to his/her illness or injury during the Activities that are not covered by such insurance policy.
- I understand and agree to abide by the Laws of Australian Football (including any modifications or amendments), and any and all USAFL, member league, or member club rules or regulations, including related to any dispute regarding my eligibility or right to participate in any Activities.
- I affirm that I am not suspended or banned from play or participation by any league or club, and I authorize the USAFL to verify my citizenship and my right to participate in any Activities.
THE UNDERSIGNED PARTICIPANT HEREBY CERTIFIES THAT I HAVE COMPLETELY READ AND UNDERSTAND THIS USAFL MEDICAL INSURANCE AGREEMENT AND RULES ACKNOWLEDGMENT FOR ADULTS (OVER 18 YEARS OF AGE) AND ITS TERMS; THAT PRIOR TO SIGNING THIS AGREEMENT, I HAVE HAD THE OPPORTUNITY TO ASK ANY QUESTIONS ABOUT THIS AGREEMENT AND TO RETAIN MY OWN ATTORNEY TO REVIEW IT ON MY BEHALF; THAT I HAVE SIGNED IT FREELY AND VOLUNTARILY AND WITHOUT ANY WRONGFUL PRESSURE OR ASSURANCE OF ANY NATURE ; THAT I UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT; AND THAT I INTEND IT TO BE A COMPLETE AND UNCONDITIONAL AGREEMENT TO CARRY MEDICAL INSURANCE. I AFFIRM I AM 18 YEARS OF AGE OR OLDER.
|
|