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LIABILITY, IMAGE RELEASE AND INDEMNITY AGREEMENT

Please read carefully before signing.

I ACKNOWLEDGE THAT MY PARTICIPATION IN ANY ACTIVITIES OR PROGRAMS OR RECEIVING ANY SERVICES AT ADIDAS THE BASE LA INCLUDES RISKS, KNOWN AND/OR UNKNOWN AND COULD CAUSE INJURY TO ME. AS A PRE-CONDITION TO ALLOWING ME TO USE ANY FACILITIES AND EQUIPMENT, OR PARTICIPATION IN ANY PROGRAMS OR UTILIZATION OF ANY SERVICES AVAILABLE IN CONNECTION WITH THE EVENT, I ACKNOWLEDGE THAT I ACCEPT THE RISKS ASSOCIATED WITH PARTICIPATION AND USE OF ANY AND ALL SUCH FACILITIES, EQUIPMENT, PROGRAMS AND SERVICES, INCLUDING BUT NOT LIMITED TO THE FOLLOWING RISKS: WORSENING OF ANY MEDICAL CONDITION OR INJURY I MIGHT HAVE, PERSONAL INJURY, THEFT OR CONTAGION. I ACKNOWLEDGE THAT PRIOR TO UTILIZING ANY SERVICES, I HAVE THE RESPONSIBILITY TO INQUIRE ABOUT ANY RISKS ASSOCIATED WITH THEM AND THAT I WILL FOLLOW ALL INSTRUCTIONS RELATED TO THE FACILITIES, EQUIPMENT, EXERCISE, PROGRAM OR SERVICE. I GRANT PERMISSION TO URBANFUTSAL LA, ADIDAS AMERICA, INC. (“ADIDAS”) AND ITS AFFILIATES THE ROYALTY- FREE AND PERPETUAL RIGHT THROUGHOUT THE WORLD TO USE, PUBLISH, BROADCAST, MODIFY, AND COPYRIGHT, ANY AND ALL CONTENT OF ME TAKEN IN CONNECTION WITH THE EVENT, INCLUDING MY NAME, IMAGE, LIKENESS, VOICE, OR ANY MATERIAL BASED ON OR DERIVED THEREFROM IN CONNECTION WITH ANY MEDIA FOR PURPOSES OF ADVERTISING, PROMOTING, AND PUBLICISING URBANFUTSAL LA AND THE ADIDAS BRAND, ITS PRODUCTS OR ITS EVENTS.

On behalf of myself and any minor children entrusted to my care, I hereby agree to release and indemnify urbanfutsal la, adidas, their respective parent corporations, subsidiaries and affiliate corporations, and all of their respective shareholders, members, officers, directors, employees, agents, successors and assigns from all liability for injury, death, property loss and damage arising out of or in connection with (i) my or my child’s participation in any activity related to the Event and the use of any facility, equipment, programs and services related to the Event, (iii) my violation of the policies of the Event, or (iv) my negligent or intentional tortious acts or omissions. This release and indemnity agreement includes claims based upon negligence by urbanfutsal la, adidas and any other person or cause. I further agree to pay urbanfutsal la and adidas all costs and legal fees expended defending against such claims or lawsuits as well as any sum paid as a result of any judgment or settlement.

If any provision of this agreement is determined to be unenforceable, all other provisions shall be given full force and effect.