Hudson Sloop Club Waterfront Wednesday Participation Form
Participant's Name
First Name
Last Name
Birthdate
-
Month
-
Day
Year
Date
2nd Participant's Name (under 18)
First Name
Last Name
Birthdate
-
Month
-
Day
Year
Date
3rd Participant's Name
First Name
Last Name
Birthdate
-
Month
-
Day
Year
Date
Participants' Legal Guardian (if under 18 years old)
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Would you like to receive emails from the Hudson Sloop Club?
Yes
No
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you agree to wear a life vest while on the docks or on the HSC vessels as directed by vessel captain or fishing instructors?
Yes
Special medical information, allergies or special concerns you would like a medical professional to be aware of should need arise:
Liability Waiver / Terms and ConditionsI the undersigned OR if under 18 the parent, parents or legal guardian of Participant do hereby consent to the aforementioned minor’s participation in the activities sponsored by or associated with The HSC. I UNDERSTAND THAT SUCH PARTICIPATION CAN INCLUDE HAZARDOUS ACTIVITIES WHICH MAY EXPOSE HIM/HER TO CERTAIN RISKS OF INJURY SUCH AS LACERATIONS, PULLS AND STRAINS, FRACTURES, CONCUSSIONS, LOSS OF LIMB, DROWNING OR EVEN DEATH. I AM FREELY AND VOLUNTARILY ALLOWING MY SON / DAUGHTER TO PARTICIPATE IN THESE ACTIVITIES WITH THE KNOWLEDGE OF THE DANGER INVOLVED AND HEREBY AGREE TO ASSUME AND ACCEPT ANY AND ALL RISKS OF INJURY OR DEATH
Yes
In consideration of this consent to participate in said programs and activities, I hereby agree, on behalf of myself OR said minor AND my/their assigns and heirs, to release, defend and hold harmless, the State of New York, Columbia County, the city of Hudson and Group Facility and all of their officers, employees and agents, HSC and all of their officers, employees and agents (collectively the “Releasees”) from and against any and all actions, claims, damages (including attorney fees) of liability arising or resulting from his/her participation in the activities sponsored by or associated with HSC nd including without limitation, damage to or destruction of any property or injury or death to any person. HSC reserves the right to photograph program participants for publicity purposes.
Yes
BY ADDING MY INITIALS BELOW I HAVE CAREFULLY READ THE SAFETY RULES, MEDICAL RELEASE AND THE TERMS AND CONDITIONS AND FULLY UNDERSTAND THEIR CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN THE RELEASEES AND MYSELF AND SIGN IT OF MY OWN FREE WILL ON BEHALF OF MYSELF OR SAID MINOR.
Continue
Continue
Should be Empty: