All Mountain MTB Camp - Adult Waiver

All Mountain MTB Adult Camp Registration Form

Please fill out all sections below
Application Form

Deadline for application: July 15, 2020

*These camps are for participants ages 18+

This camp will run at Knox Mountain the evenings of July 20 and 22nd with a full day at Big White on Sunday July 26th.

There is an extra day option add on for Big White on Sunday August 9th.
Full name of applicant *

First Name Last Name
Best Phone Number to reach you at *

Area Code Phone Number
Age of applicant as of July 1, 2020 *
How did you hear about us? *
Place of Residence as of June 1, 2020 *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
What level of Mountain Biker are you? *
If you responded No to the previous question, please tell us how many days' experience you have and how long ago.
Do you own a bike with single or dual suspension?(If providing your own bike it must have front suspension and disk brakes for the town based riding, and for the Big White day your bike must have full suspension with disc brakes and pass an inspection by a member of the Big White team. Our instructors will check it prior to the first day to ensure it is suitable for the program and in good working order. *
Why are you interested in learning how to mountain bike/improving your skills? *
If you need rentals from Big White please fill out below.

For the day at Big White it is strongly recommended that you wear full armour and a full face helmet. Please input the sizing below so they can reserve you a set for the day.
Please enter the participants height, weight, shirt and shoe size (for supply and rental purposes): *
Helmet Size
Upper Body Pads
Knee Pads
Please indicate which camp you are registering for: *

July 20/22/26, 2020
All Mountain MTB Camp Permission Form

Please read all the information below and sign where it is requested. Additional waivers from Big White will need to be completed in person.
On my behalf I agree to the following:

ASSUMPTION OF RISKS: I acknowledge and accept that mountain biking involves risks, dangers and hazards in addition to those normally associated with bicycle riding and that injuries are a common and expected part of mountain biking. The program may take place on steep and rugged terrain and will expose the rider to many risks, dangers and hazards. The terrain may be un‐inspected, uncontrolled and unsafe due to constantly changing conditions. The inherent risks, hazards and dangers include but are not limited to the following: collision with other riders, vehicles, bicycles, trees, tree stumps, tree wells or other objects; fences and other man made structures; mechanical failure of equipment; rapid an uncontrolled acceleration on hills and inclines; changing weather conditions; unsafe terrain including steep or slippery sections, cliffs, rocks, holes, or crevices; extreme variation in cycling terrain; encounters with domestic and non domestic animals; falling or being thrown off the mountain bike; negligence on the part of the instructors – including the failure to protect the participant from the risk, dangers and hazards of mountain biking or to predict the whether the terrain is safe for mountain biking; negligence of other riders. I understand and acknowledge that no amount of caution, experience and instruction can eliminate all of the risks involved and I freely assume all such risks, dangers and hazards and the possibility of personal injury, death, property damage and damages or loss resulting therefrom. I for myself and on the behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Elevation Outdoors Experiential Programs Association, their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event (“Releasees”), WITH RESPECT TO ANY AND ALLINJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER CAUSED BY NEGLIGENCE OF THE RELEASEES OR OTHERWISE.Elevation Outdoors is requesting that you fill out the form below stating that you have read and are aware of the inherent risks of this activity. We are also requesting that you fill out the attached medical form with all relevant details and BC medical numbers.Please be assured that all appropriate safety measures and risk management practices will be exercised while the program is being delivered. Helmets are mandatory. Body armour will also be worn on the downhill days. Participants will be supervised during all bike trips, and ‘black’ or most difficult runs will not be utilized unless appropriate skill has been demonstrated beforehand. It is our intention to create a lasting, learning experience for the participants involved and we will be taking their safety very seriously.
I have read the above statement and accept the risks involved for myself. *
Participants Full Name *

First Name Last Name
Please Read and Sign - Participants Signature *

I have read the above letter and understand the inherent risks in the activity of mountain biking, as well as the risks of participating in the program. I still want to participate with this in mind. Clear
Photo and Video Release - Participant Signature

Elevation Outdoors and/or Big White has permission to use my photograph/video/audio recordings to promote the organization. I understand that the images may be used in various formats not limited to print publications, online publications, presentations, websites, and social media. Clear
Email - Please enter your email address so that we can send you confirmation and information about the program. *
example@example.com
I agree to receive emails/electronic communication from Elevation Outdoors and Big White about future program opportunities. *

Yes No
Input Todays Date *

Month Day Year
Date
Participants Medical Form

Please fill out all the requested information
Participants Name *

First Name Last Name
Participants Date of Birth *

Month Day Year
Date
Participants BC Care Card Number *
Please provide the correct care card number
Participants Phone number - Provide preferred contact number *

Area Code Phone Number
Emergency Contact - Provide who we should call in case of emergencies. *

First Name Last Name
Emergency Contacts relationship with the participant. *
Emergency Contact Phone Number - Please provide the number of the person listed above. *

Area Code Phone Number
Medical History
Have you ever suffered from Asthma? *
If Yes, please provide if they have medication and what it is/usage.
Do you suffer from any allergies? *
If yes please list what they are and any medications they take, if it is anaphylactic and if they have an EpiPen.
Do you suffer from any of the following? *
Please select any/all that apply. Hold Cntrl or Command to select multiple entries.
If you selected any of the above options, please provide more information about them below.
Please let us know what the issue is/was, any medications they are on, and best practices for managing it.
When was the participants last Tetanus shot? *
Answer as accurately as possible. If not within the last 10 years, participant may receive a tetanus injection by a medical officer if they receive a tetanus prone wound.
Are you on any ongoing medications? *
Please provide details of medications, dosage, and frequency taken.
Please select any of the following non-prescription medications you give permission for you to receive if needed. *
Hold Cntrl or Command to select multiple options.
Is there anything about your situation that we need to be aware of in regards to participation in this program? Is there anything that may impact others in the program we need to be aware of? *
example - Behavioural or Medical concerns
In the case of accident or illness, I authorize the caregiver to administer first aid and/or be taken to the nearest emergency centre. I consent to receive medical treatment. I consent that in the event of severe injury or illness the means of transportation may be ambulance at a cost to myself. *
Participant Signature *

I declare that the information which I have provided on this form is complete and correct and that I will notify the program if any changes occur. I authorize the facilitator to consent, where it is impractical to communicate with me, to receive such medical or surgical treatment as may be deemed necessary. Clear
COVID 19 RELEASE OF LIABILITY, WAIVER OF CLAIMS, ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT

BY SIGNING THIS DOCUMENT YOU WILL WAIVE CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE.
ASSUMPTION OF RISK:

I/ we, the undersigned, are aware that:

(a)   the Province of British Columbia has declared a State of Emergency as a result of the Covid 19 pandemic;

(b)   the Provincial Health Officer has provided guidelines for the prevention and control of Covid 19, and ELEVATION OUTDOOR EXPERIENTIAL PROGRAMS ASSOCIATION (“Elevation”) is offering outdoor experiential programs to children, with rules and procedures in place to follow the provincial guidelines, however Elevation cannot and does not guarantee that the Participant will not come into contact with the Covid 19 virus as a result of participating in Elevation Programs;

(c)   participating in the programs provided by Elevation involves inherent risks as a result of the interaction between participants, instructors, and other people, shared equipment, and excursions to public spaces, including the risk of exposure to the Covid 19 virus, and the risk of contracting and spreading the Covid 19 virus, and any related infections or complications;

(d)   if Elevation has reason to believe that the Participant has been exposed to the Covid 19 virus, or is showing any symptoms of the Covid 19 virus, Elevation will not allow the Participant to continue participating in the Elevation programs, and will not be able to provide a refund, if applicable, for any paid spots in Elevation programs.

I/we are the parent(s) or legal guardian of the Participant. I/we are aware that participating in programs provided by Elevation involves an inherent risk of contracting and/or spreading the Covid 19 virus. I am also aware that the risks, dangers and hazards referred to above exist throughout the entire duration of the Elevation programs, and that the Participant may remain asymptomatic for an extended period of time after participating the Elevation programs, even though the Participant may have come into contact with the Covid 19 virus, and the Participant may be contagious.

I/ we confirm that Elevation has made no representations, warranties or other assurances with respect to the safety of participating in Elevation programs and has warned me of the risks associated with the Participant participating in Elevation programs. I/we freely accept and fully assume all such risks, dangers and hazards and the possibility of infection, illness, associated medical complications, personal injury, death, mandatory quarantine or self-isolation measures to the Participant and the Participant’s household or family members, as well as damage or loss, resulting therefrom.

I/we acknowledge and agree that this waiver will continue to apply even if the Provincial State of Emergency is lifted, and that Elevation reserves the right to refuse participation for anyone based on a suspected case of COVID-19 or suspected exposure to it, or if any Participant refused to follow safety protocols.

RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT

In consideration of the Participant being permitted to participate in Elevation programs, I/ we hereby agree as follows:

1. TO WAIVE ANY AND ALL CLAIMS that I/we have now or may in the future have against Elevation in connection with the Participants participation in Elevation programming, including Elevation’s directors, officers, employees, agents, and representatives (all of whom are hereinafter collectively referred to as the “RELEASEES”);

2. TO RELEASE THE RELEASEES from any and all liability for any loss, damage, injury or expense that I/we or the Participant may suffer as a result of the Participant participating in Elevation programs due to Covid 19, or due to any cause whatsoever, INCLUDING NEGLIGENCE, BREACH OF CONTRACT, OR BREACH OF ANY STATUTORY OR OTHER DUTY OF CARE, INCLUDING ANY DUTY OF CARE OWED UNDER THE OCCUPIERS LIABILITY ACT, R.S.B.C. 1996, C.337, ON THE PART OF THE RELEASEES;

3. TO HOLD HARMLESS AND INDEMNIFY THE RELEASEES from and against any and all claims, actions, damages, liability and expenses in connection with loss of life, personal injury sustained or damages arising from the Participant participation in Elevation programs, including the loss of any registration fees, and to indemnify Elevation from and against any claims that the Participant may have, now or in the future, against Elevation as a result of the Participant participating in Elevation programs; and

4. This agreement shall be effective and binding upon my/our heirs, next of kin, executors, administrators, assigns and representatives in the event of my/our death or incapacity.

In entering into this Agreement, I/we am not relying upon any oral or written representations or statements made by the Releasees other than what is set forth in this Agreement.

I/WE HAVE READ AND UNDERSTAND THIS AGREEMENT AND I/WE ARE AWARE THAT BY SIGNING THIS AGREEMENT I/WE ARE WAIVING CERTAIN LEGAL RIGHTS WHICH I/WE OR MY/OUR HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS AND ASSIGNS MAY HAVE AGAINST THE RELEASEES.

This agreement must be completed in full, signed, dated and witnessed before participating in the program.
Signed on the date of: *

Month Day Year
Date
Participant Signature: *

Clear
Name of Witness: *

First Name Last Name
Witness Signature: *

Clear
Date of Submission *

Month Day Year
Date

My Products

All Mountain MTB Camp W Big White Rental $ 325.00 CAD

Select this option if you would like the Big White rental package for the resort day.

Quantity

Big White Rental Damage Coverage $ 25.00 CAD

This is optional, but recommended.

All Mountain MTB Camp No Big White Rental $ 275.00 CAD

Registration fee without the Big White rental for the resort day.

Quantity

Extra Big White day Add On W Bike Rental - Sunday August 9 $ 189.00 CAD

Extra day of riding at Big White. This is the best price you will find for lessons and rentals, exclusive only to participants in this program.

Extra Big White day Add On - No bike rental - Sunday August 9 $ 100.00 CAD

Extra day of riding at Big White. This is the best price you will find for a 2 hour lesson and 2 hour guided ride with lunch all season long.

Total $ 0.00 CAD

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All Mountain MTB Adult Camp Registration Form

If you need rentals from Big White please fill out below.

All Mountain MTB Camp Permission Form

Participants Medical Form

Medical History

COVID 19 RELEASE OF LIABILITY, WAIVER OF CLAIMS, ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT