PERSONAL INFORMATION
First name:
Last name
Address:
City:
State:
Zip:
Phone: Home
Format: (000) 000-0000.
Work
Format: (000) 000-0000.
I WILL ATTEND THESE DATES:
Thursday August 13,2026
Friday, August 14, 2026
Saturday, August 15, 2026
Sunday, August 16, 2026
Tandem Bicycling (Bicycle Built for Two)
Participant
Captain/Guide
I WILL BE ATTENDING WITH:
Attendant
Significant Other
Friend
Guide Dog
Please indicate number of guides, and/or friends attending with you if any!
PARTICIPANTS - PLEASE INDICATE TYPE OF DISABILITY
High Partial Vision
Manual Wheelchair
Low Partial Vision
Electric Wheelchair
Totally Blind
Other (please describe)
+ Guides/Volunteers and Participants, please submit your $100 Registration Fee per person attending along with this
application. Make checks payable to Ski for Light. + Each person is required to submit an application with appropriate
signatures along with the Release and Waiver of Liability Form. (Reverse side)
+ Applications due no later than August 1, 2026.
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SKI FOR LIGHT RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT
IN CONSIDERATION of being permitted to participate in the Ski For Light EVENT(S), THE UNDERSIGNED, for himself, his personal representatives, heirs, and next of kin:
1. HEREBY RELEASES, WAIVES, DISCHARGES, AND COVENANTS NOT TO SUE the organizers, volunteers, participants, sanctioning organizations, Bob Marshall Camp, equipment manufacturers and/or owners, and owners and lessees of the premises used to conduct the Ski for Light event(s) and any others involved in any way, directly or indirectly, in the Ski for Light event(s,) all of whom are referred to here as "Releasees," FROM ALL LIABILITY OF ANY SORT OR TYPE AND BASED ON ANY THEORY, LEGAL, CONTRACTUAL, EQUITABLE, OR OTHERWISE, TO THE UNDERSIGNED, his personal representatives, assigns, heirs and next of kin FOR ANY AND ALL LOSS, INJURY AND/OR DAMAGE, INCLUDING DEATH ARISING OUT OF OR RELATED IN ANYWAY TO THE SKI FOR LIGHT EVENT(S), WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.
2. HEREBY AGREES TO INDEMNIFY AND HOLD HARMLESS the Releasees and each of them FROM ANY LOSS, LIABILITY, DAMAGE, OR COST they may incur arising out of or related to the SKI FOR LIGHT EVENTS WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.
3. HEREBY KNOWINGLY, WILLINGLY, AND VOLUNTARILY ASSUMES FULL RESPONSIBILITY FOR ANY RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE arising out of or related to the SKI FOR LIGHT EVENT(S) whether caused by the NEGLIGENCE OF RELEASEES or otherwise.
4. HEREBY acknowledges that THE ACTIVITIES OF THE SKI FOR LIGHT EVENT(S) ARE VERY DANGEROUS and involve the risk of serious injury and/or death and/or property damage. THE UNDERSIGNED also expressly acknowledges that INJURIES RECEIVED MAY BE COMPOUNDED OR INCREASED BY NEGLIGENT RESCUE OPERATIONS OR PROCEDURES AND/OR ACTIONS OF THE RELEASEES.
5. HEREBY agrees that this Release and Waiver of Liability, Assumption of Risk and Indemnity Agreement extends to all acts of negligence by the Releasees, INCLUDING NEGLIGENT RESCUE OPERATIONS and is intended to be as broad and inclusive as is permitted by the laws of the State of South Dakota and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.
6. HEREBY acknowledges that this Release and Waiver of Liability, in addition to Ski for Light event(s), also applies to any and all injuries, damages, and/or death that may occur as a result of the condition of any of the premises upon which any Ski for Light event(s) is held.
I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW,
I HAVE READ THIS WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT.
PRINTED NAME
SIGNATURE
DATE
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Month
-
Day
Year
Date
WITNESS/LEGAL GUARDIAN SIGNATURE IF UNDER AGE 18
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