FUTSAL TA

PARTICIPATION ACKNOWLEDGMENT AND RELEASE

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IN CONSIDERATION OF the risks involved in participating in FUTSAL (hereinafter referred to as the "Activity"); and

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IN CONSIDERATION OF my desire to participate in said Activity and being granted the right to participate therein;

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I, on behalf of myself, my heirs, executors, administrators, assigns, or personal representatives (hereinafter collectively referred to as "Releasor," "I" or "me," which terms shall also include Releasor's parents or guardian if Releasor is under 18 years of age), knowingly and voluntarily enter into this WAIVER AND RELEASE OF LIABILITY, thereby waiving any and all rights, claims, or causes of action arising from my participation in the Activity;

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I HEREBY release and forever discharge FTA Holdings, LLC, located at 101 S. Tryon Street, 27th Floor, Charlotte, NC 28280, their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors, and assigns (hereinafter collectively referred to as "Releasees"), from any physical or psychological injury that I may suffer as a direct result of my participation in the aforementioned Activity.

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I AM VOLUNTARILY PARTICIPATING IN THE AFOREMENTIONED ACTIVITY AND I AM PARTICIPATING IN THE ACTIVITY ENTIRELY AT MY OWN RISK. I ACKNOWLEDGE THE RISKS ASSOCIATED WITH PARTICIPATING IN THIS ACTIVITY, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO: PHYSICAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, ILLNESS, DISFIGUREMENT, TEMPORARY OR PERMANENT DISABILITY (INCLUDING PARALYSIS), ECONOMIC OR EMOTIONAL LOSS, AND DEATH. I UNDERSTAND THAT THESE INJURIES OR OUTCOMES MAY ARISE FROM MY OWN OR OTHERS' NEGLIGENCE, CONDITIONS RELATED TO TRAVEL TO AND FROM THE ACTIVITY, OR FROM CONDITIONS AT THE ACTIVITY LOCATION(S). I FURTHER UNDERSTAND THAT I AM RESPONSIBLE FOR MY OWN SAFETY DURING THE ACTIVITY AND AGREE TO FOLLOW ALL SAFETY INSTRUCTIONS PROVIDED BY FTA Holdings, LLC OR ITS AGENTS. NOTWITHSTANDING, I ASSUME ALL RELATED RISKS, BOTH KNOWN AND UNKNOWN TO ME, BY VOLUNTARILY PARTICIPATING IN THIS ACTIVITY.

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I FURTHER AGREE to indemnify, defend, and hold harmless the Releasees against any and all claims, suits, or actions of any kind whatsoever for liability, damages, compensation, or otherwise brought by me or anyone on my behalf, including attorney's fees and any related costs.

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I FURTHER ACKNOWLEDGE that Releasees are not responsible for errors, omissions, acts, or failures to act of any party or entity conducting a specific event or activity on behalf of Releasees. In the event that I require medical care or treatment, I authorize FTA Holdings, LLC to provide all emergency medical care deemed necessary, including but not limited to, first aid, CPR, the use of AEDs, emergency medical transport, and sharing of medical information with medical personnel. 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 am aware and understand that I should carry my own health insurance.

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I FURTHER ACKNOWLEDGE that this Activity may involve a test of a person's physical and mental limits and may carry with it the potential for death, serious injury, and property loss. I agree not to participate in the Activity unless I am medically able and properly trained, and I agree to abide by the decision of the FTA Holdings, LLC official or agent, regarding my approval to participate in the Activity.

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I HEREBY GRANT FTA Holdings, LLC permission to use photographs, video recordings, or other media of me or my minor child captured during the Activity for promotional or commercial purposes, without compensation and without further permission. I waive any right to inspect or approve the use of the images or recordings.

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I HEREBY ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS "WAIVER AND RELEASE" AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. I EXPRESSLY AGREE TO RELEASE AND DISCHARGE FTA Holdings, LLC AND ALL OF ITS AFFILIATES, MANAGERS, MEMBERS, AGENTS, ATTORNEYS, STAFF, VOLUNTEERS, HEIRS, REPRESENTATIVES, PREDECESSORS, SUCCESSORS, AND ASSIGNS, FROM ANY AND ALL CLAIMS OR CAUSES OF ACTION AND I AGREE TO VOLUNTARILY GIVE UP OR WAIVE ANY RIGHT THAT I OTHERWISE HAVE TO BRING A LEGAL ACTION AGAINST FTA Holdings, LLC FOR PERSONAL INJURY OR PROPERTY DAMAGE.

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To the extent that statute or case law does not prohibit releases for ordinary negligence, this release is also for such negligence on the part of FTA Holdings, LLC, its agents, and employees.

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I agree that this Release shall be governed for all purposes by North Carolina law, without regard to any conflict of law principles. This Release supersedes any and all previous oral or written promises or other agreements.

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In the event that any damage to equipment or facilities occurs as a result of my or my family's or my agent's willful actions, neglect, or recklessness, I acknowledge and agree to be held liable for any and all costs associated with any such actions of neglect or recklessness.

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THIS WAIVER AND RELEASE OF LIABILITY SHALL REMAIN IN EFFECT FOR THE DURATION OF MY PARTICIPATION IN THE ACTIVITY, INCLUDING THIS INITIAL AND ALL SUBSEQUENT EVENTS OF PARTICIPATION.

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THIS AGREEMENT was entered into at arm's-length, without duress or coercion, and is to be interpreted as an agreement between two parties of equal bargaining strength. Both Participant and FTA Holdings, LLC agree that this agreement is clear and unambiguous as to its terms, and that no other evidence shall be used or admitted to alter or explain the terms of this agreement, but that it will be interpreted based on the language in accordance with the purposes for which it is entered into.

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In the event that any provision contained within this Release of Liability shall be deemed to be severable or invalid, or if any term, condition, phrase or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this agreement shall remain in full force and effect. If a court should find that any provision of this agreement to be invalid or unenforceable, but that by limiting said provision it would become valid and enforceable, then said provision shall be deemed to be written, construed, and enforced as so limited.

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I, THE UNDERSIGNED PARTICIPANT, AFFIRM THAT I AM OF THE AGE OF 18 YEARS OR OLDER, AND THAT I AM FREELY SIGNING THIS AGREEMENT. I CERTIFY THAT I HAVE READ THIS AGREEMENT, THAT I FULLY UNDERSTAND ITS CONTENT AND THAT THIS RELEASE CANNOT BE MODIFIED ORALLY. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND THAT I AM SIGNING IT OF MY OWN FREE WILL.

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PARENT / GUARDIAN WAIVER FOR MINORS

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In the event that the participant is under the age of consent (18 years of age), then this release must be signed by a parent or guardian, as follows:

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I HEREBY CERTIFY that I am the parent or guardian of registrant, named on the registration, and do hereby give my consent without reservation to the foregoing on behalf of this individual.