The Fieldhouse at Canaan

Assumption of Risk – Waiver of Liability – Indemnification – Acknowledgments

All ages under 18 MUST HAVE the following form signed by their parent or legal guardian. EVERYONE MUST HAVE this initialed and COMPLETELY filled out.

Agree and Acknowledge

I understand and acknowledge that if I proceed to register online and to sign the waiver electronically, that, under the Electronic Transactions Act, such electronic registration and electronically signed Waiver document will be valid and enforced in the same manner as a hand-signed document that exists in physical form and that a record or signature may not be denied legal effect or enforceability under law solely because it is in electronic form.

Basic Information

Use parent or guardian information if under 18

Contact Information

Use parent or guardian information if under 18

Minor Information

Enter the information for the children for which you are responsible for:

The Fieldhouse at Canaan (hereafter referred to as TFC) provides the participant with many benefits. TFC makes available numerous activities to the participant including, but not limited to: Frisbee, soccer, lacrosse, field hockey, flag football, volleyball, baseball/softball catch, kickball, aerobics, fitness training, small weights, dodgeball, whiffle ball, birthday parties, and overnight lock-ins. The participant has an opportunity to: develop fitness, have fun, be active rather than sedentary, compete with others, learn teamwork, improve health, improve appearance, interact socially, and be involved in wholesome recreation. The required physical exertion, ranging from mild to very strenuous, is suitable for most levels of fitness and skill.

While the many benefits of these activities are apparent, TFC and its staff regard participant safety as a top priority and feel it is important that the participant (and parent/guardian of minor participants)(hereafter referred to as PARTICIPANT/PARENT) understand that there are risks inherent in all physical activity. TFC takes great care to reduce the risks associated with the many physical activities offered at the facility. Among the procedures taken are safety rules and warnings, safety rules signage, available instruction, trained supervisors at all facility areas, appropriate safety equipment, personnel certified in emergency care, and on-site AEDs.

However, regardless of the care taken to avoid injuries, some risks are inherent in the activity and cannot be totally eliminated without changing the nature of the activity. Examples of inherent risks include, but are not limited to, dropping a weight; hit by a bat, field hockey sticks, lacrosse stick, or a ball; falls on hard surfaces while competing; heat-related illness; collisions with other participants, supports, or structures; over-exertion; contacting a hard surface; landing incorrectly; uneven or imperfect outdoor surfaces; and injuries during recreational games at birthday parties or lock-ins. Inherent risks also include unexpected equipment failure, unknown facility hazards, careless behavior by the participant or a co-participant, and errors in judgment by TFC instructors, supervisors, and other employees.

TFC feels that it is important that the PARTICIPANT/PARENT understand that three types of injuries can occur. Minor injuries are the most common and include, but are not limited to, muscle soreness, headaches, sprains, abrasions, and bruises. Serious injuries are less common, but do occur occasionally. They include, but are not limited to, broken bones, concussions, torn ligaments, eye injuries, cuts, and internal injuries. Catastrophic injuries are very rare; but TFC feels that every PARTICIPANT/PARENT should be aware of the slight possibility. These injuries include permanent disability, brain injury, paralysis and even death.

Assumption of Inherent Risks: I, the PARTICIPANT/PARENT understand that all activities of TFC include inherent risks that cannot be totally eliminated regardless of the care taken by TFC. I, the PARTICIPANT/PARENT, 1) know, 2) understand, and 3) appreciate the types of injuries inherent in TFC activities. I, the PARTICIPANT/PARENT, hereby assert that participation is voluntary and the PARTICIPANT/PARENT knowingly assume all inherent risks of the activity.

Waiver of Liability for Ordinary Negligence of TFC: In consideration of permission to use the property, facilities, equipment, and services of TFC, today and on all future dates, I, the PARTICIPANT/PARENT, on behalf of [myself, my spouse, heirs, personal representatives, and assigns (hereafter referred to as the Releasing Parties)] do hereby waive, release, discharge and covenant not to sue TFC [including, The Fieldhouse at Canaan, LLC, owners, directors, officers, employees, volunteers, independent contractors, agents and equipment suppliers (hereafter referred to as the Protected Parties] from liability from any and all claims arising from the ordinary negligence of the Protected Parties.

This agreement applies to 1) personal injury (including death) from incidents or illnesses arising from participation in TFC activities including, but not limited to: recreational, practice, or competitive activity; events; organized or individual training and conditioning activities; tests; classes and instruction; as an observer or spectator; and individual use of all facilities. This applies to all facilities including: indoor turf field, outdoor fields, equipment, and all other premises including the associated sidewalks and parking lots and to 2) any and all claims resulting from the damage to, loss of, or theft of property.

Indemnification: PARTICIPANT/PARENT also agree to hold harmless, defend, and indemnify TFC (that is, defend and pay any judgment and costs, including investigation costs, attorney’s fees, and related expenses) from any and all claims of Releasing Parties arising from participation in TFC Activities, (including those arising from the inherent risks of the activity or the ordinary negligence of Protected Parties).

I, the PARTICIPANT/PARENT, further agree to hold harmless, defend, and indemnify TFC against any and all claims of co-participants, rescuers, and others arising from the conduct of the participant in TFC activities.

Clarifying Clauses: I, the PARTICIPANT/PARENT confirm that:

  1. This agreement supersedes any and all previous oral or written promises or agreements. I understand that this is the entire agreement between me and TFC and cannot be modified or changed in any way by representations or statements by any agent or employee of TFC;
  2. The foregoing Assumption of Risk, Waiver of Liability, and Indemnification Agreement is intended to be as broad and inclusive as is permitted by the laws of the State of New York and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect; and
  3. If legal action is brought, the appropriate trial court for the County of Columbia in the State of New York has the sole and exclusive jurisdiction and that only the substantive laws of the State of New York shall apply.
  4. I will engage in good faith efforts to mediate any dispute that might arise. Any agreement reached will be formalized by a written contractual agreement at that time. Should the issue not be resolved by mediation, I agree that all disputes, controversies, or claims arising out of participation in TFC shall be submitted to binding arbitration in accordance with the applicable rules of the American Arbitration Association then in effect.

Acknowledgements to Promote Participant Safety: These affirmations aid TFC in providing for the health and safety of the participant.

Health Status. The participant affirms that he or she:

  • Possesses no health problems or physical disabilities that would make participation unwise.
  • Will cease activity and inform the activity leader or supervisor of any health problem that arises during participation.
  • Possesses sufficient skills, coordination, and physical fitness to safely participate.
  • Has been advised by TFC to seek medical clearance prior to participation.

Medical Care. The participant affirms that he or she:

  • Agrees that TFC can administer emergency first aid, CPR, and AED when deemed necessary.
  • Authorizes to medical care should that be deemed necessary by TFC.
  • Authorizes TFC to secure emergency medical care and transport if deemed necessary.
  • Agrees to assume all cost of the care and transportation listed above.

Rules and Safety. The participant affirms that he or she agrees:

  • To report all injuries (even minor injuries) so that TFC may make a record of the injury.
  • To wear all required safety gear during participation.
  • To inform TFC of any conduct or condition that creates a hazard for participants or others.
  • That TFC has authority to halt my participation if it endangers the participant or others.
  • To follow all rules of the activity and TFC:
    1. No fighting or otherwise abusive/unsafe misconduct. One infraction halts TFC participation.
    2. No spitting, no hanging on nets/goals, no balls at ceiling, no balls off the field.
    3. WATER ONLY on field. No food, gum-chewing, drinks, glass on field.
    4. Playing shoes are cleaned outside of TFC.
    5. Prompt entry and exit from field to be considerate of programs before and after.
    6. No un-supervised children under 16 in viewing area. 1-to-2 supervising parent to children ratio.
    7. Put your trash, empty bottles in garbage or recycling bin. Wipe table and sweep floor if needed.

Acknowledgment of Understanding: I, the Parent, assert that I have explained the risks of the activity to my minor son or daughter and that he or she understands this Agreement. I, the PARTICIPANT/PARENT, have read and understand this Agreement. I understand that I am giving up substantial rights, including the right of both the participant and the parent or guardian to sue for damages in the event of death, injury or loss. I, the PARTICIPANT/PARENT, acknowledge that I am voluntarily signing this agreement, and intend my signature to be a complete release of all liability, including that due to inherent risks or the ordinary negligence by the Protected Parties, to the greatest extent allowed by law of the State of New York.


By entering my name below and clicking the “Submit Waiver” button below, I indicate my acceptance and delivery of this waiver and release. I acknowledge that I have been given an opportunity to prevent or correct any error in connection with this waiver form. If I have submitted this waiver form in error, I will immediately notify you of the error, revoke my signature as instructed, and refrain from participating in any event or activity to which the waiver applies, as provided in Section 204(b) of the Uniform Electronic Transactions Act.