Pickleball For Youth, Waiver, Consent & Media Release

Club/Organization Name: Markham Pickleball Club

Program Name: Learn to Play

Program Location: Markham Civic Centre Parking lot Courts,

1. Parental/Guardian Consent for Participation

I, the undersigned parent or legal guardian of the minor child named below, hereby give permission for my child to participate in the Learn to Play Series hosted by the Markham Pickleball Club at the Markham Civic Centre Courts for July – October 2025..

Child’s Name: ________________________________________

Date of Birth: _________________________________________

Parent/Guardian Name: ________________________________

2. Acknowledgment of Risk and Release of Liability

I understand that sports activities, including pickleball, carry inherent risks of injury or harm, including but not limited to falls, sprains, collisions, or other physical injuries.

By signing this form:

● I confirm that my child is physically fit to participate.

● I voluntarily assume all risks related to participation.

● I release and hold harmless the organization, its directors, volunteers, agents, and affiliates from any and all claims, liability, or damages arising from my child’s participation, except in cases of gross negligence or intentional misconduct.

3. Emergency Medical Authorization

In the event of an emergency where I cannot be reached, I authorize the coach or program staff to secure necessary medical care for my child, including transportation and treatment.

Medical conditions or allergies: _______________________________

Emergency Contact Name: ______________________

Phone Number: ___________________

4. Media Release Consent (Photos, Video & Interviews)

I grant permission to the coach and/or club/organization to:

● Photograph and/or film my child during sessions, games, or events

● Use such images, video, and audio for promotional, educational, or informational purposes in media such as websites, social media, newsletters, flyers, press releases, and news coverage

● Release such content to third parties for media coverage (e.g., local news, league reporting)

I understand that:

● My child will not be identified by full name without my separate, written consent

● There will be no compensation for use of this media

● I may revoke this permission in writing at any time, but it will not apply retroactively

☐ I DO NOT consent to photography or filming of my child. (check box if opting out)

6. Signatures

By signing below, I confirm I have read, understood, and voluntarily agree to the above terms.

Parent/Guardian Signature: _______________________________

Date: ____________________