Release Of Liability Waiver

My role*

CLUB MEMBERCLUB GUESTVOLUNTEER

Your Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Phone Number*

Area CodePhone Number

Email*

example@example.com

Birth Date*

MonthDayYear

Are you under 18 at time of signing this waiver*

NOYES

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 understant 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; and,

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; and,

3) I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS PADDLESPORT RISK MANAGEMENT, LLC; and PINK PHURREE BREAST CANCER SURVIVORS DRAGON BOAT TEAM 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 (“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, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY.

AS PARENT OR LEGAL GUARDIAN OF THE PARTICIPANT I AFFIRM THAT I HAVE EXPLAINED THE TERMS AND CONDITIONS OF THE WAIVER TO THE MINOR PARTICIPANT AND MINOR HAS ACKNOWLEDGED THEY UNDERSTAND THEY WILL BE GIVING UP SIGNIFICANT RIGHTS TO SUE.

Participant Signature*

Print Name*

First NameLast Name

Date*

Date

Name of Parent/ Guardian*

First NameLast Name

Phone Number*

Area CodePhone Number

Relationship to Participant*

Parent/Legal Guardian Signature*

RELEASE OF LIABILITY WAIVER