Release Of Liability Waiver

Your Role*

New club memberRenewing club memberGuest Paddler

Are you under 18 Yrs Old:*

NoYES

A PARENT OR LEGAL GUARDIAN MUST COMPLETE AND SIGN WAIVER IF PARTICIPANT IS UNDER 18 YRS OLD.

Guest Participation Date:*

Date of first paddle

Guest Participant: This waiver will start the date of your first paddle and apply to future participation dates up to the maximum allowed. If you join the club as a full member this waiver will serve as your member waiver until the end of the current membership.

Member/Participant Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Phone Number*

Area CodePhone Number

Email*

If a minor - add parent email

Emergency Contact:*

First NameLast Name

Emergency Contact Phone:*

Area CodePhone Number

In consideration of being allowed to participate in any way in this sports activity, related events and activities, the undersigned appreciates and acknowledges:

1) I understand the risk of injury or illness from the activities involved in this sport is significant, including the potential for permanent paralysis and death; and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury or illness does exist; and, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM ALL NEGLIGENCE OF THE RELEASEES or others and assume full responsibility for my participation.

2) I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such hazard to the attention of the nearest official immediately. I understand that consumption of alcoholic beverages or mind altering drugs prior to or during any on water paddling session is strictly prohibited. I confirm I am in good physcial condition to participate in vigorous physical activity and do not have any medical conditions that would be adversly affected by my participation. I agree I will remove myself from participation if I feel ill and bring my condition to the attention of the nearest paddler or team leader.

3) I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY WAIVE, RELEASE AND INDEMNIFY PADDLESPORT RISK MANAGEMENT, LLC; MINNESOTA CANOE ASSOICATION; their officers & directors, officials, agents,and/or employees, other participants, sponsoring agencies, commissions, sponsors, advertisers, volunteers, coaches, steerers, and, if applicable, owners and lessors of premises used to conduct club/ activities/ special events (“RELEASEES”), WITH RESPECT TO ANY AND ALL INJURY, ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

4) I also acknowledge that photographs and video may be taken of me in my participation in, and attendance at this event or club activity, and hereby freely agree to allow without restriction all uses of such photos and videos in the reporting of club activities, special race, and/or in the promotion of such, its location, other sporting events, sport in general, and/or related purposes.

By signing below I acknowledge that I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY.

Signature*

MINORS (UNDER AGE 18) - A PARENT/LEGAL GUARDIAN MUST COMPLETE AND SIGN BELOW.

This is to certify that I, as parent/legal guardian with legal responsibility for this PARTICIPANT, I have read the waiver of liability to the minor participant and confirm they fully understand its contents and therefore, I do consent and agree to his/her Waiver, Release and Indemnification, as provided above, of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child's involvement in the paddling program as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES to the fullest extent permitted by law.

Minor Date of Birth*

MonthDayYear

Name of Parent/Legal Guardian*

First NameLast Name

Phone Number*

Area CodePhone Number

Relationship to Participant*

Signature of Parent/Legal Guardian*

Date*

DateHourMinutesAM/PM Option

WAIVER, RELEASE & INDEMNITY