Liability Release Waiver

Liability Release Waiver

Please complete and sign this waiver before participating in Carleton County Pickleball Club sessions without a membership.
This form is for non members participating in pickleball sessions created by Carleton County Pickleball Club.

By signing this waiver you acknowledge that the liability waiver is good for the session date and is allowable for only two sessions before expectation is that you join Pickleball Canada, Pickleball New Brunswick and become a member of the Carleton County Pickleball Club. Signing this waiver indicates that the participant is aware that they as a guest are not covered by the insurance provided to Carleton County Pickleball Club via Pickleball Canada.
Participant Full Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Are you 18 years of age or older?
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Mailing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Activity/Event Details

Confirm the details of the activity/event you are participating in.
Event Date

MonthDayYear
Date
Event Location
Organizer / Organization Name
Emergency Contact

Who should we contact in case of an emergency?
Emergency Contact Full Name

First NameLast Name
Relationship to Participant
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Medical Notes / Allergies

Optional: Share relevant information that may help in an emergency.
Do you have any medical conditions, allergies, or other notes we should be aware of?
Medical notes / allergies (please describe)
Waiver Acknowledgments

Please review and confirm the statements below.
Acknowledgment of risks and assumption of risk
Release of liability / hold harmless and indemnification

I release, waive, discharge, and hold harmless the Carleton County Pickleball Club and Pickleball Canada, its officers, volunteers, agents, and affiliates from any and all claims, liabilities, demands, actions, or causes of action arising out of or related to my participation, including those caused by negligence to the fullest extent permitted by law. I also agree to indemnify and defend them from any claims arising from my acts or omissions during participation.
Rules and safety agreement
Consent to emergency medical treatment
Agreement Confirmation
Participant Signature

Please sign below.
Participant Signature
Signature Date

MonthDayYear
Date
Parent/Guardian Information (Minors Only)

If the participant is under 18, a parent/guardian must complete and sign this section.
Parent/Guardian Full Name

First NameLast Name
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email Address
example@example.com
Parent/Guardian Relationship to Participant
Parent/Guardian Consent
Parent/Guardian Signature
Parent/Guardian Signature Date

MonthDayYear
Date
Photo/Video Release
Should be Empty:

Liability Release Waiver

This form is for non members participating in pickleball sessions created by Carleton County Pickleball Club.

Activity/Event Details

Emergency Contact

Medical Notes / Allergies

Waiver Acknowledgments

Participant Signature

Parent/Guardian Information (Minors Only)