Bemidji Curling Club Waiver and Release of Liability

Bemidji Curling Club Waiver and Release of Liability

Please fill out the form below to sign and submit your waiver for this season.
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
E-mail*
Waiver and Release of Liability - Read Before Signing
In consideration of being allowed to participate in any way in the programs of the BEMIDJI CURLING CLUB and the UNITED STATES CURLING ASSOCIATION, INC. (USCA), their related events and activities, the undersigned acknowledges, appreciates and agrees that:
1. I AM VOLUNTARILY PARTICIPATING IN CURLING ( the ‘ACTIVITY’) AND I AM PARTICIPATING IN THE ACTIVITY ENTIRELY AT MY OWN RISK. I AM AWARE OF THE RISKS OF 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 OR THE CONDITION OF THE ACTIVITY LOCATION. I UNDERSTAND THAT WHILE PARTICULAR SKILLS, EQUIPMENT AND PERSONAL DISCIPLINE MAY REDUCE THIS RISK, THE RISK OF SERIOUS INJURY DOES EXIST. NONETHELESS, I KNOWINGLY AND FREELY ASSUME ALL RELATED RISKS, BOTH KNOWN AND UNKNOWN TO ME, OF MY PARTICIPATION IN THIS ACTIVITY EVEN IF THE RISKS AROSE FROM THE NEGLIGENCE OF THE RELEASEES, OR OTHERS, AND I ASSUME FULL RESPONSIBILITY FOR MY PARTICIPATION.
2. I will agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual, significant hazard during my presence and participation, I will remove myself from participation and bring such to the attention of the Bemidji Curling Club and the USCA immediately.
3. I, for myself, my heirs, executors, administrators, assigns, personal representatives and next of kin, knowingly and voluntarily enter into this waiver and release of liability and hereby waive any and all rights, claims or causes of action of any kind whatsoever arising out of my participation in the Activity, and do hereby release and forever discharge THE BEMIDJI CURLING CLUB AND THE USCA, their officers, officials, affiliates, managers, members, agents, attorneys, staff, volunteers, other participants, sponsoring agencies, sponsors, advertisers, and if applicable owners and lessors of premises used for the activity (Releasees), for any physical or psychological injury, including but not limited to illness, paralysis, death, damages, economical or emotional loss, that I may suffer as a direct result of my presence or participation in the Activity, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
I HAVE READ THIS WAIVER AND RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
MEMBER/PARTICIPANT SIGNATURE*
Age*
Date*

MonthDayYear
Date
FOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE
(UNDER AGE 18 AT THE TIME OF REGISTRATION)

This is to certify that I, as parent/guardian with legal responsibility for this participation, do consent and agree to his/her waiver and release as provided above of all the Releasees, and for myself, my child and our heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasee from any and all liabilities incidents to my minor child’s involvement or participation in these programs as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.
PARENT/GUARDIAN SIGNATURE*
Date*

MonthDayYear
Date
Should be Empty:

Bemidji Curling Club Waiver and Release of Liability

Waiver and Release of Liability - Read Before Signing