NORTH ALLEGHENY SPORTS NETWORK Athletic Director

NORTH ALLEGHENY SCHOOL DISTRICT

SECTION 8 - INSURANCE WAIVER FORM

Insurance Waiver and Release Form

Dear Parent,

Your child has indicated an interest in participating in the North Allegheny High School Athletic Program.   We know that it is your will as well as ours that every possible precaution be taken to protect our students from injury.  We do our utmost to promote this by proper training, by the use of good protective equipment, by supervising all activities, and by encouraging good safety habits.

Despite all our efforts, accidents do happen occasionally in athletics as elsewhere.  The school is not legally liable for medical or hospital expenses, damages related to pain and suffering, loss of earning capacity or any other expenses or damages resulting from athletic injuries incurred in interscholastic sports.

Although the North Allegheny School District provides school insurance, the school insurance does not cover all expenses.  The best available insurance for the amount of money involved is a combination of our own school insurance and your own personal family insurance. 

We the undersigned parent or guardian, intending to be legally bound, do hereby release, discharge, and waive the North Allegheny School District from any liability for any injury to our child (above named) resulting from any cause whatsoever in connection with our child participating in a North Allegheny Athletic Program(s) or any other interscholastic activity.  We further hereby agree to indemnify and hold harmless the North Allegheny School District from any expenses that we may incur in connection with the participation of our child in the above mentioned activity.

Warning and Notification of Risk

Playing, practicing or participating in a sport can be a dangerous activity involving risk of injury.  There is no limitation to the nature or severity of the possible injuries in some sports.  Some sports injuries can result in serious permanent impairment or be life threatening.  Unfortunately, injury may occur simply due to the nature of the sport without the occurrence of any unusual event and without fault.

I have read the above WARNING.  I am aware and understand the risks of practicing, participating in and playing interscholastic activities.  I recognize the importance of following the coaches’ instructions regarding the activity. 

                                Signature of Student ___________________________________________________

We are the parents/legal guardian of the above named student.  We have read the Insurance Waiver and Release, as well as the Warning and Notification of Risk and understand the risks of our child participating in interscholastic activities.

                                Signature of Parent/Guardian ____________________________________________

______  This is to acknowledge that my child has my permission to participate in __________________________  

                even though he/she has not purchased additional insurance against injuries sustained in interscholastic athletics.

______  This is to acknowledge that my child is adequately covered by our own personal insurance against injuries

                sustained in interscholastic athletics.  He/she has my permission to participate in _______________________

                                Signature of Parent/Guardian ____________________________________________    

QUESTIONS SHOULD BE ADDRESSED TO ATHLETIC DIRECTOR BOB BOZZUTO AT 724-934-7238