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VOLUNTARY WAIVER AND RELEASE

This Voluntary Waiver and Release Agreement (“Agreement”) is hereby executed by the undersigned, or if the undersigned is under the age of 18 years, then the undersigned’s parent or legal guardian (together with any heir, successor, representative or assign, collectively as “Participant”) in favor and for the sole and exclusive benefit of the Released Parties (as defined herein).

In connection with Participant’s involvement in training, contest, promotional activity or in any other event which may take place at any location in which Houston Kickers training and events takes place or which involves Houston Kickers coach(es) by Participant, including, without limitation, any tournament, game, match, practice or any other event at any predetermined location (hereinafter referred to as an “Event”), Participant hereby certifies, warrants, represents, agrees and covenants to Houston Kickers, Mr. Raffi Gregorian, the City of Houston and each of their respective affiliates, officers, employees, contractors, agents, successors and assigns, the “Released Parties”), that he/she is:

Participant Certification:

• (1) FREE OF ANY MENTAL OR PHYSICAL CONDITION, AILMENT OR INJURY (MEDICAL OR OTHERWISE) WHICH WOULD, IN AND OF ITSELF OR IN CONJUNCTION WITH ANY OTHER CIRCUMSTANCE, INCLUDING BUT NOT LIMITED TO THOSE ACTIVITIES ASSOCIATED WITH THE EVENT, (i) IMPAIR, PREVENT OR PROHIBIT PARTICIPANT FROM ENGAGING IN SUCH EVENT ACTIVITIES OR (ii) BE AFFECTED, AGGRAVATED OR WORSEN IN ANY WAY AS A RESULT, DIRECTLY OR INDIRECTLY, OF PARTICIPANT’S INVOLVLEMENT IN SUCH EVENT;
• (2) OF SOUND MIND AND BODY AND NOT UNDER THE INFLUENCE OF ALCOHOL OR ANY ILLICIT OR PRESCRIPTION DRUG OR MEDICATION WHICH MAY IN ANY WAY IMPAIR PARTICIPANT’S ABILITY TO ENTER INTO THIS AGREEMENT, FULLY UNDERSTAND THE RESPECTIVE INTENT AND MEANING OF ALL OF THE TERMS AND PROVISIONS HEREOF AND TO PARTICIPATE IN THE EVENT;
• (3) ENTERING INTO THIS WAIVER AND RELEASE AGREEMENT VOLUNTARILY, BY PARTICIPANT’S OWN FREE WILL, ACT AND DEED, WITHOUT ANY UNDUE INFLUENCE FROM THE ORGANIZERS OR ANY OTHER THIRD PARTY.

ASSUMPTION OF RISK:

PARTICIPANT AGREES THAT PARTICIPANT DERIVES A MATERIAL BENEFIT FROM THE EVENT AND/OR PARTICIPANT’S INVOLVEMENT THEREIN. BY EXECUTION OF THIS AGREEMENT, PARTICIPANT AGREES AND ACKNOWLEDGES THAT THE EVENT MAY INVOLVE STRENOUS ACIVITY, WHICH MAY BE POTENTIALLY HAZARDOUS, AND PARTICIPANT HEREBY ASSUMES ALL RISKS ASSOCIATED WITH PARTICIPATING IN THE EVENT, INCLUDING, WITHOUT LIMITATION, FALLS, CONTACT WITH OTHER PARTICIPANTS, THE EFFECTS OF WEATHER AND THE CONDITION OF SURFACES.

Signature or Parent/Guardian Signature if participant is under 18: (required)

Name or Parent/Guardian Name if Participant is under 18: (required)

Date: (required)