NIH R&W FENCING CLUB

Sponsored by the NIH Recreation and Welfare Association

All persons participating in the NIH R&W Fencing Club or in classes organized by the Club are required to read, agree to, and sign this waiver before participating.

I,____________________________________________(or parent for the participant if under 18), assume all risks (including possible bodily injury and death) involved in participating in the NIH R&W Fencing Club and do for myself (or my child), my heirs, executors, administrators, and assignees waive, release and forever discharge any and all rights and claims which may have or which hereafter accrue to me against the NIH Recreation and Welfare Association, and the NIH R&W Fencing Club, including its coaches, officers, members, or guests, along with any sponsors and their representatives and successors.

I agree to follow all safety procedures (proper clothing) and to immediately alert my coach of any problem that would affect my ability to fence safely.

In case of emergency I agree to permit treatment by any licensed physician and transport to an emergency room, if necessary.

Emergency Contact:____________________________________

Health Insurance Number:______________________________

Phone/E-mail:_________________________________________

___________________________________________________________

Fencers name

________________________________________ _________________

Signature (parent if under 18) Date