Southeast AKYSB - Northeast Table Tennis Doubles Tournament

ADULT CONSENT & RELEASE FORM
To be completed by the participant 18 years or older.

I, the undersigned, acknowledge that I am voluntarily participating in Northeast Table Tennis Tournament
(the “Activity”) being held on or between April 4, 2026 arranged in whole or in part by His
Highness Prince Aga Khan Shia Imami Ismaili Council for the United States of America, its regional and local councils, boards,
portfolios, affiliates, members, officers, leaders, employees, staff, volunteers, representatives, and/or agents (the “Institutions”), and all
their heirs, executors, successors, representatives, and agents, agree as follows:
1. I hereby agree to strictly observe, follow, and comply with all policies, procedures, expectations, rules, regulations, requirements,
restrictions, and guidelines, whether written or verbal, set forth for the Activity (the “Rules”), as well as all consequences that result
against me due to violation of the Rules, including but not limited to removal from the Activity. I acknowledge that the Institutions have
sole discretion to determine all aspects of the Activity, including the Rules and the consequences for their violation, and to take any
actions they deem necessary to ensure the safe and proper conduct of the Activity. Except as expressly agreed to in writing by the
Institutions, I will bear all costs relating to my participation in the Activity or any incidental expenses contemplated herein.
2. I voluntarily and knowingly assume all risks connected with the Activity or my participation in the Activity, including but not
limited to the risk of loss, property damage, or personal injury, including death, whether involving, in part or in whole, the conduct of
one or more Institutions.
3. I hereby irrevocably and unconditionally release and forever discharge the Institutions, its employees, volunteers, staff, leaders,
representatives, agents, and/or affiliates (“Indemnified Parties”) from any and all liabilities, losses, claims, demands, suits, actions,
causes of action, damages, expenses, and costs (including but not limited to court costs and attorneys’ fees) whatsoever (“Claims”),
arising out of or in connection with any loss, harm, or personal injury, including death, that may be sustained by me or another, or any
loss of or harm to property belonging to me or another, and in any way connected with the Activity or my participation in the Activity,
including but not limited to transportation or lodging, whether involving, in part or in whole, the conduct of one or more Institutions. I
also covenant not to pursue against the Indemnified Parties for any Claims as described in this section.
4. I hereby agree to indemnify and hold harmless the Institutions for any Claims that they may incur due to my participation in the
Activity, whether asserted against any Indemnified Party by a third party or the participant, whether involving, in part or in whole, the
conduct of one or more Institutions.
5. I hereby consent to any medical treatment which I may need, and which arises in connection with the Activity or my participation
in the Activity; provided, however, nothing in this agreement shall be deemed an obligation by the Institutions to provide any such
medical treatment. I understand that the Institutions do not carry healthcare insurance that covers me, and I am solely responsible for
the cost of all medical treatment. I also authorize the Institutions to take any measures necessary in their sole discretion to protect the
health of safety of me and others, including but not limited to removing me from the Activity and/or informing my family members,
other Institutions, and medical or public health professionals of any actual or suspected concerns in connection with my physical health
(e.g., a communicable disease that may spread to others) or mental and emotional health (e.g., behavior that may cause harm to me or
others), and any medical or other information related to such concerns.
6. I grant to the Institutions and each of their representatives, assigns, and affiliates, the absolute and irrevocable right, permission,
consent, and license to take photographs, videos, and sound recordings of me and/or my property during the Activity, and to use, reuse,
publish, republish, distribute, and/or modify these photographs, videos, and sound recordings, in whole or in part, individually or in
connection with other material, and in any and all media now or hereafter known, and for any permissible purpose whatsoever.
7. This agreement shall be binding on behalf of my representatives, family members, heirs, successors, assigns, estate, and any other
persons or entities claiming through or under me or any of them. This agreement is intended to benefit each of the Institutions who may
enforce the terms of the agreement.
8. Any controversy or claim arising out of or relating to the Activity and/or this agreement shall, before the filing of a lawsuit or any
other legal proceeding, first be submitted for mediation administered by the American Arbitration Association under its Commercial
Mediation Procedures.
9. The provisions of this agreement should be applied to the greatest extent allowed by law. In the event that any provision of this
agreement is held invalid or without full legal effect, the remaining provisions shall remain in full force and effect. The delay or failure
of one or more Institutions to exercise any right in connection with this agreement is not to be construed as a waiver of that right.
10. The signatory to this agreement represents and warrants that he or she is authorized to affix their electronic signature to this
document and such signature is placed in accordance with the Electronic Signatures in Global and National Commerce Act (e-Sign) and
local statute and laws. Each signatory understands and acknowledges that their electronic signature has full legal effect and
enforceability.
I HAVE READ AND VOLUNTARILY SIGN THIS PARTICIPATION AND RELEASE AGREEMENT AND INTEND IT TO
BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED
BY LAW. I ACKNOWLEDGE THAT I AM AT LEAST 18 YEARS OF AGE AND FULLY COMPETENT.

MINOR CONSENT & RELEASE FORM
To be completed by the Parent/Guardian of the participant (Under 18).

I, the undersigned, am a parent or legal guardian of the child(ren) whose name(s) are printed at the bottom of this agreement (the
collectively, if more than one, “Minor”). This agreement is between me (on behalf of Minor) and the Institutions (as defined below).
The Undersigned acknowledges that each of the below Minor individuals wishes to voluntarily participate in
Northeast Table Tennis Tournament (the “Activity”) being held on or
between April 4, 2026, arranged in whole or in part by His Highness Prince Aga Khan Shia Imami
Ismaili Council for the United States of America, its regional and local councils, boards, portfolios, affiliates, members, officers, leaders,
employees, staff, volunteers, representatives, and/or agents (the “Institutions”), and all their heirs, executors, successors,
representatives, and agents, agree as follows
1. Each Minor will observe, follow, and comply with all policies, procedures, expectations, rules, regulations, requirements,
restrictions, and guidelines set forth for the Activity (the “Rules”), as well as all consequences that result against the Minor due to
violation of the Rules, including but not limited to removal from the Activity. I acknowledge that the Institutions have sole discretion to
determine all aspects of the Activity, including the Rules and the consequences for their violation, and to take any actions they deem
necessary to ensure the safe and proper conduct of the Activity. Except as expressly agreed to in wring by the Institutions, I will bear all
costs relating to each Minor’s participation in the Activity.
2. I voluntarily and knowingly assume all risks connected with the Activity or each Minor’s participation in the Activity, including
but not limited to the risk of loss, property damage, or personal injury, including death, whether involving, in part or in whole, the
conduct of one or more Institutions.
3. I hereby release and discharge the Institutions, its employees, volunteers, staff, leaders, representatives, agents, and/or affiliates
from any and all liabilities, losses, claims, demands, suits, actions, causes of action, damages, expenses, and costs (including but not
limited to court costs and attorneys’ fees) whatsoever (“Claims”), arising out of or in connection with any loss, harm, or personal injury,
including death, that may be sustained by Minor or another, or any loss of or harm to property belonging to Minor or another, and in any
way connected with the Activity or each Minor’s participation in the Activity, including but not limited to transportation or lodging,
whether involving, in part or in whole, the conduct of one or more Institutions. I also covenant not to pursue against the Institutions any
Claims as described in this section.
4. I hereby agree to indemnify and hold harmless the Institutions for any Claims that they may incur due to Minor’s participation
in the Activity, whether asserted against any Indemnified Party by a third party or the Participant, whether involving, in part or in whole,
the conduct of one or more Institutions.
5. I hereby consent to any medical treatment which Minor may need and which arises in connection with the Activity or Minor’s
participation in the Activity; provided, however, nothing in this agreement shall be deemed an obligation by the Institutions to provide
any such medical treatment. I understand that the Institutions do not carry healthcare insurance that covers any individuals or Minor,
and I am solely responsible for the cost of all medical treatment. I authorize the Institutions to take any measures necessary in their sole
discretion to protect the health of safety of each Minor and others, including but not limited to removing Minor from the Activity and/or
informing Minor’s family members, other Institutions, and medical or public health professionals of any actual or suspected concerns
in connection with the Minor’s physical health (e.g., a communicable disease that may spread to others) or mental and emotional health
(e.g., behavior that may cause harm to the Minor or others), and any medical or other information related to such concerns.
6. I grant to the Institutions and each of their representatives, assigns, and affiliates, the absolute and irrevocable right, permission,
consent, and license to take photographs, videos, and sound recordings of the Minor and/or Minor’s property during the Activity, and to
use, reuse, publish, republish, distribute, and/or modify these photographs, videos, and sound recordings, in whole or in part, individually
or in connection with other material, and in any and all media now or hereafter known, and for any permissible purpose whatsoever.
7. This agreement shall be binding on behalf of my representatives, family members, heirs, successors, assigns, estate, and any other
persons or entities claiming through or under me or any of them. This agreement is intended to benefit each of the Institutions who may
enforce the terms of the agreement.
8. Any controversy or claim arising out of or relating to the Activity and/or this agreement shall, before the filing of a lawsuit or any
other legal proceeding, first be submitted for mediation administered by the American Arbitration Association under its Commercial
Mediation Procedures.
9. The provisions of this agreement should be applied to the greatest extent allowed by law. In the event that any provision of this
agreement is held invalid or without full legal effect, the remaining provisions shall remain in full force and effect. The delay or failure
of one or more Institutions to exercise any right in connection with this agreement is not to be construed as a waiver of that right.
I HAVE READ AND VOLUNTARILY SIGN THIS PARTICIPATION AND RELEASE AGREEMENT AND INTEND IT TO
BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED
BY LAW. I ACKNOWLEDGE THAT I AM AT LEAST EIGHTEEN (18) YEARS OF AGE AND FULLY COMPETENT, AND
THAT I HAVE THE LEGAL AUTHORITY TO SIGN THIS AGREEMENT ON BEHALF EACH MINOR NAMED BELOW.

Marketing Details

Visit SE Council Website for more details.