In consideration of the risk of injury or illness that exists while participating in a sport or recreational event held by Mary Free Bed Wheelchair and Adaptive Sports.

I hereby, for myself and/or my minor child, consent to voluntarily participating in the above activity.

I am aware of the risks associated with participating in this activity, including that associated with the exposure of communicable diseases, including, but not limited to, Covid-19.

I am aware that Mary Free Bed Rehabilitation Hospital will follow CDC guidelines as it relates to prevention of illness, but that I, and/or my minor child, will participate in the activity entirely at my, or my minor child’s, own risk.

I hereby certify that the participant does not have any symptoms of/ tested positive for Covid-19, or has been exposed to anyone that has had symptoms of/has tested positive for Covid-19 in the last 14 days. These symptoms include:

• Fever
• New or worsening cough with respiratory illness
• Sore throat with respiratory illness
• Difficulty breathing or shortness of breath
• Chills or shaking with chills
• Loss of taste/smell

I understand that it is my duty to notify Mary Free Bed Rehabilitation Hospital if any symptoms or exposure develop prior to the event. In the event that symptoms or exposure does arise, I, and/or my minor child, agree not to attend the activity.

I understand that risk of infection may arise from my own or others’ negligence, including contact with other participants. Nonetheless, I assume all related risks, both known and unknown to me and/or my minor child’s participation in this activity.

I agree to indemnify, defend and hold harmless Mary Free Bed Rehabilitation hospital, it’s employees, agents, and volunteers, against any claims, suits or actions of any kind whatsoever for any and all injuries, illness, liability, damages, compensation or otherwise brought by me or anyone on my behalf.

I agree that Mary Free Bed Rehabilitation Hospital, its employees, agents, and volunteers, are not responsible for errors, omissions, acts or failures to act of any party or entity conducting the specific event or activity on behalf of Mary Free bed.

In the event that I should require medical care or treatment, I authorize Mary Free Bed Hospital to provide or access emergency medical care as they deem necessary, including but not limited to first aid, CPR, use of AED’s, emergency medical transport. I further agree to assume all costs involved and agree to be financially responsible for any costs incurred as a result of such treatment.

I authorize the release of medical information with medical personnel upon initiation or transfer of medical care.

I hereby acknowledge that I have carefully read this “Waiver and Release” and fully understand that by signing this, I agree to release and hold harmless Mary Free Bed Rehabilitation Hospital, employees, agents, and volunteers from any and all claims related to my participation.

Please note: if a person is under 18 years of age, parent or legal guardian must sign this form.

I hereby give my permission to Mary Free Bed Rehabilitation Hospital of Grand Rapids, Michigan, to use my (or my child’s) name and/or likeness, city and state, in
the form of photographs, videotape, interviews, slides, movies, or recordings, and the use of statements made by me or attributed to me (or my child) for publicity
purposes or similar promotions relating to Mary Free Bed Rehabilitation Hospital, including use on the Mary Free Bed Web site. Furthermore, I grant Mary Free
Bed Rehabilitation Hospital any and all rights to said use without further compensation. It is my understanding that my signature below releases Mary Free Bed
Rehabilitation Hospital from any financial or legal responsibility for the use of the media relations/advertorial/promotional materials named above.

Please note: if a person is under 18 years of age, parent or legal guardian must sign this form.

I, the undersigned (participant), being of lawful age or have, of my own accord, chosen to participate in Mary Free Bed programming. I am being permitted to participate at my own risk and assume full responsibility for any injuries or damages that may occur to me or my equipment during or in transit to and from the program(s).
In consideration of being allowed to participate in MFB programs, I, the undersigned, for myself, my heirs, my successors and assignees, agree to indemnify and
forever hold harmless Mary Free Bed Rehabilitation Center, Mary Free Bed directors, officers, members, agents, and employees, and their respective agents, successors, legal representatives, heirs and legatees and each of them from and against any and all claims suits, damages, losses, expenses (including attorney fees), and liabilities which they or any of them may occur to be subjected to in any way be reason of, arising out of, or related to my participation, including my equipment or provided equipment and travel to and from programs, excluding any claims arising out of the negligence of the MFB leaders or otherwise of the program.
I am in good health and may participate in wheelchair/adaptive sports. My activity should not be limited or participation hindered because of any physical ailment. I realize that any sport may cause an individual serious injury and the participation in any sport is an acceptance of some risk of injury. If any emergency arises involving my physical well-being. I give MFB full permission to protect and assist me as deemed necessary. I will agree to pay any medical expenses or any other expenses related to my participation.

I certify my signature (below) signifies consent with this release.

Player Code of Conduct

At no time shall an athlete use disrespectful, abusive, or obscene language to coaches, teammates, parents, referees, or visitors. Respect your coach, teammates, parents, opponents and officials. Never argue with an official’s decision, coach’s actions or with others in public. If you have an issue ask your team manager and coach to set up a meeting with all concerned individuals. Unsportsmanlike conduct in the form of gestures, or other dramatic displays of individual anger are prohibited.

Fighting before, during, or following a game, whether on or off the court/ice, is strictly forbidden and will be subject to disciplinary action, regardless of any penalties imposed by the game officials.

The use of drugs on AND off the court/ice is absolutely forbidden at any time while participating in any sports program activity. For legally aged adults, the use of alcohol on the court/ice is absolutely forbidden during practices or during games. Each player shall respect the property of others, including wheelchairs, at all times. Any athlete who intentionally damages the practice facility or equipment while participating in any sport program activity is subject to discipline by fining or suspension by both Mary Free Bed Rehabilitation Hospital and the program management.

Coaches and/or the coordinator shall have the authority to dismiss any athlete during practice for open personal criticism of teammates, abusive or obscene language, or unsportsmanlike conduct. Discipline problems shall be referred to the coaches and Team Coordinator for appropriate action.
Mary Free Bed reserves the right to become involved in disciplinary actions if they feel the severity of the activity reflects poorly on their organizations.

In the event that any of the above behaviors take place within the season of play:

1. The offending player will be given one verbal and written warning if the infraction is minor.
2. Second offense within the season, player will not play at the next tournament on the schedule, and will result in a mandatory meeting with parent/guardian (if under 18) or player.
3. Based on the severity of the behavior, players will be subject to more severe discipline up to and including expulsion from the program. The level of punishment will be at the discretion of the program coordinators, coaches and/or the partner organizations.

This contract must be signed by the first practice each season by the player in order to participate.

Coaches and Volunteers Code Of Conduct

Coaches and volunteers will set a good example of personal conduct at all times, and shall promote TEAM and INDIVIDUAL development.

Coaches may take reasonable disciplinary action including dismissal from practice if indicated. Athletes and parents will be told exactly why such action was taken.

Obscene or abusive language, unsportsmanlike displays, intoxication, or substance abuse will not be tolerated.
Coaches and volunteers must respect the physical and emotional boundaries of the athletes.

It is expected that all volunteers achieve the standard for acceptable performances in their position.

Actions or behaviors that the Mary Free Bed feels are inappropriate may result in discipline up to and including discharge. (Please see conflict resolution section of manual.)
This contract must be signed by the first practice each season by the coach and or volunteer before the first practice.


Parent Code Of Conduct
Encourage your child to play by the rules. Remember, children learn best by example, so applaud the good plays of both teams.

Do not embarrass your child by yelling at players, coaches or officials. By showing a positive attitude toward the game and all of its participants, your child will benefit
Know and study the rules of the game and support the officials on and off the ice. Any criticism of the officials only hurts the game.

Applaud a good effort in both victory and defeat, and enforce the positive points of the game. Work toward removing the physical and verbal abuse in youth sports.
Parents will demonstrate positive sportsmanship during games/practices and will not use inappropriate, negative or disparaging comments/language to players, coaches, referees or opposing team family/players.

No adult is permitted on the court/ice at any time, unless a medical emergency exists, and the adult is summoned by an official. Parents are not allowed on the bench during games and practices, unless approved by the Program and Coaching Coordinator.

Parents must recognize that their child's coaches are volunteers and they are responsible for developing team play, as well as individual player skills. If you have a concern about court/ice time, discipline, or personal problems, please discuss it with the Program and Coaching Coordinator in private. Any unresolved problems should be brought to the attention of the Executive Director. Any written communication or complaints must be signed to be considered (we do not act on anonymous complaints).

In the event that any of the above behaviors take place, the offending parent, guardian or relative will not be able to attend the next tournament on the schedule or even tournaments for the remaining season based on agreement between the team coordinator, coaches and partner organization’s discretion due to the severity of the behavior.

This contract must be signed by the first practice each season by the parents/guardian or family member who is responsible for their child and in attendance during practices and games or their player will not be able to participate.