Liability Waiver — Coach Ramiro's Water Polo Performance Lab

Participant (Athlete) Information

Enter the name and date of birth of the athlete who will be participating in the Program.

First Name *

Last Name *

Date of Birth *

Parent / Guardian Information

Because the participant is under 18, a parent or legal guardian must complete and sign this waiver.

Parent/Guardian Full Name *

Relationship *

Contact Information

If the participant is a minor, provide the parent or guardian's contact information.

Phone *

Email *

Emergency Contact

Full Name *

Phone *

Relationship to Participant *

1. Statement of Activity

Coach Ramiro's Water Polo Performance Lab ("the Program") provides water polo instruction, training, and skill development sessions conducted at aquatic facilities in the Carlsbad, California area. Sessions may include, but are not limited to: swimming drills, treading exercises, ball handling, shooting practice, passing drills, positional training, scrimmage play, strength and conditioning exercises conducted in and around the pool, and video review of recorded sessions.

The Program is operated by Coach Ramiro LLC, a California limited liability company (EIN: 99-1568778).

2. Acknowledgment & Assumption of Risk

I understand and acknowledge that participation in water polo training involves inherent risks that cannot be eliminated regardless of the care taken to avoid them. These risks include, but are not limited to:

Drowning or near-drowning incidents
Head, neck, or spinal injuries from contact with other participants, the pool wall, or pool bottom
Concussions and traumatic brain injuries
Muscle strains, sprains, tears, and overuse injuries
Broken bones, dislocations, and joint injuries
Lacerations, bruises, and abrasions from physical contact
Eye injuries from ball or hand contact
Ear injuries including swimmer's ear and eardrum perforation
Respiratory distress, exercise-induced asthma, or hyperventilation
Cardiac events including heart attack or sudden cardiac arrest
Heat-related illness (heat exhaustion, heat stroke) or hypothermia
Illness from waterborne pathogens or chemical irritants
Injuries resulting from equipment use or malfunction
Injuries sustained while traveling to, from, or between training locations
Emotional or psychological distress

I, on behalf of myself and/or my minor child, voluntarily assume all risks associated with participation in the Program, whether or not specifically identified above, and whether arising from the ordinary negligence of Coach Ramiro LLC, its officers, employees, agents, contractors, or other participants.

3. Waiver and Release of Liability

In consideration of the participant being permitted to participate in the Program, I, on behalf of myself, the participant, and our respective heirs, executors, administrators, assigns, and personal representatives, hereby release, waive, discharge, and covenant not to sue Coach Ramiro LLC, its owners, officers, members, managers, employees, agents, independent contractors, affiliates, successors, assigns, facility owners, facility operators, and all other persons or entities acting on its behalf (collectively, the "Released Parties") from any and all liability, claims, demands, actions, causes of action, suits, costs, expenses (including attorneys' fees), and damages of any kind arising out of or related to the participant's participation in the Program.

This release applies to claims arising from the negligence of the Released Parties, but does not apply to claims arising from their gross negligence or willful misconduct.

I understand that this waiver is intended to be as broad and inclusive as permitted by California law and that if any portion is held invalid, the remainder shall continue in full force and effect.

4. Indemnification & Hold Harmless

I agree to indemnify, defend, and hold harmless the Released Parties from any and all claims, demands, suits, judgments, losses, costs, and expenses (including reasonable attorneys' fees) brought by or on behalf of myself, my minor child, or any third party, arising out of or related to participation in the Program. This includes, but is not limited to, claims arising from my own acts, omissions, or negligence, or those of the participant named herein.

5. Media Release Optional

During training sessions, Coach Ramiro LLC may capture photographs, video recordings, and audio recordings of participants. Media consent is not required for participation in the Program. If neither option below is selected, no media of the participant will be used beyond the training session itself.

If you wish to grant media permissions, you may select one or both of the following:

Educational & Training Use I grant Coach Ramiro LLC permission to use media of the participant for educational and training purposes, including session playback for athlete development, instructional content on The Water Polo School platform, and coaching analysis materials shared with the participant and their family. Promotional & Commercial Use I grant Coach Ramiro LLC permission to use media of the participant for promotional and commercial purposes, including marketing materials, social media posts, website content, advertising campaigns, and any other business-related publications.

Media consent may be revoked at any time by sending written notice to ramiro.d.mosquera@gmail.com. Revocation applies to future use only and does not require removal of materials published prior to the revocation date.

6. Medical Declaration

Parents/guardians: please indicate if your child has any of the following conditions. Adult participants: indicate your own.

Asthma Heart Condition Seizure Disorder Diabetes Allergies Prior Concussion Joint/Bone Injury None of the above

Additional medical information or conditions the coach should be aware of:

I certify that the participant is physically fit and has no medical conditions that would prevent safe participation in water polo training, other than those disclosed above. I agree to notify Coach Ramiro LLC immediately of any changes in the participant's health or medical status.

7. Emergency Medical Authorization

In the event of an emergency where the participant requires immediate medical attention and I (or the parent/guardian) cannot be reached, I hereby authorize Coach Ramiro LLC and its agents to consent to emergency medical treatment, including but not limited to: first aid, CPR, AED use, ambulance transport, hospitalization, and any medical procedures deemed necessary by qualified medical personnel to protect the life and health of the participant.

I understand that Coach Ramiro LLC will make reasonable efforts to contact the emergency contact listed above before authorizing non-emergency treatment. I accept full financial responsibility for any medical expenses incurred.

8. Equipment & Facility Acknowledgment

I acknowledge that the Program uses aquatic facilities and equipment that are not owned or operated by Coach Ramiro LLC. I agree to:

Follow all facility rules, posted signage, and lifeguard instructions at all times
Inspect any equipment provided before use and immediately report any defects or concerns to the coach
Provide my own personal equipment (swimsuit, cap, wetsuit if required) in safe and functional condition
Accept that pool conditions (temperature, chemical levels, weather) may vary and can affect training
Not hold Coach Ramiro LLC responsible for conditions, hazards, or incidents caused by the facility or its staff

9. Arbitration & Governing Law

Any dispute arising out of or related to this waiver or participation in the Program shall be resolved through binding arbitration administered by the American Arbitration Association (AAA) under its Commercial Arbitration Rules. Arbitration shall take place in San Diego County, California. The arbitrator's decision shall be final and binding, and judgment may be entered in any court of competent jurisdiction.

This waiver shall be governed by the laws of the State of California, without regard to its conflicts of law provisions.

Any claim must be brought within one (1) year of the date of the incident giving rise to the claim, or it shall be permanently barred.

10. Severability

If any provision of this waiver is found to be unenforceable or invalid by a court of competent jurisdiction or arbitrator, that provision shall be modified to the minimum extent necessary to make it enforceable, or severed if modification is not possible. All remaining provisions shall continue in full force and effect.

Electronic Signature

By checking the box and typing your name below, you agree that your electronic signature is the legal equivalent of your handwritten signature on this waiver, pursuant to the California Uniform Electronic Transactions Act (Cal. Civ. Code § 1633.1 et seq.) and the federal E-SIGN Act (15 U.S.C. § 7001 et seq.). If signing on behalf of a minor, your signature binds both you and the participant.

I have read and understand this entire waiver. I voluntarily agree to its terms, on behalf of myself and/or the participant named above, and sign it of my own free will.

Full Legal Name (typed signature) *

Date *

Parent / Guardian Signature

As the parent or legal guardian of the minor participant named above, I hereby consent to their participation in the Program and agree to all terms of this waiver on their behalf.

I am the parent or legal guardian of the participant and I authorize their participation under the terms of this waiver.

Parent/Guardian Full Legal Name *