bcskateboarding.org

REGISTRATION FORM

Full Legal Name of Participant:_________________________________________________________

Address:___________________________________________________________________________

City:_____________________________________Province:_______Postal Code:_________________

Phone:__________________________________Email:______________________________________

Date of Birth :______________________________Gender:___________________________________

Parent/Guardian Name:________________________________________________________________

Address(If different from above):________________________________________________________

City:_____________________________________Province:_______Postal Code:_________________

Phone:__________________________________Email:______________________________________

Completed and Signed Waiver: YES / NO (Circle one)

Parent/Guardian Signature:_____________________________________________________________

Comments:_________________________________________________________________________

SPONSORED BY:

BARREN’S SPORT SHOP, KASLO &  THE BLACK RUSSIAN SKATE TEAM, CASTLEGAR

RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AND PARENTAL/GUARDIAN CONSENT AGREEMENT

(“AGREEMENT”)

IN CONSIDERATION of being permitted to participate in any way in the Kaslo Skateboard Competition, I, for

myself for personal representatives, assigns, heirs, and next of kin:

1.ACKNOWLEDGE, agree, and represent that I understand the nature of Skateboard Activities and that

I am qualified, in good health, and in proper physical condition to participate in such Activity. I

further agree and warrant that if at any time I believe conditions to be unsafe, I will immediately

discontinue further participation in the Activity.

2.FULLY UNDERSTAND THAT: (a) SKATEBOARD ACTIVITIES INVOLVE RISKS AND DANGERS OF

SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS, AND DEATH (“RISKS”);

(b) these Risks and dangers may be caused by my own actions or inactions, the actions or inactions

of others participating in the Activity, the condition in which the Activity takes place, or THE

NEGLIGENCE OF THE RELEASEES NAMED BELOW; (c) there may be OTHER RISK AND SOCIAL AND

ECONOMIC LOSSES either not known to me or not readily foreseeable at this time; and I FULLY

ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND

DAMAGES I incur as a result of my participation or that of the minor in the Activity.

3.HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE ANY SPONSOR OR ORGANIZER, their

respective administrators, directors, agents, officers, members, volunteers, and employees, other

participants, advertisers, and, if applicable, owner and lessors of premises on which the Activity takes

place, (each considered one of the “RELEASEES” herein) FROM ALL LIABILITY, CLAIMS, DEMANDS,

LOSSES, OR DAMAGES ON MY ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN

PART BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, INCLUDING NEGLIGENT RESCUE

OPERATIONS AND I FURTHER AGREE that if, despite this RELEASE AND WAIVER OF LIABILITY,

ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT I, or anyone on my behalf, makes a claim

against any of the Releasees, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE

RELEASEES from any litigation expenses, attorney fees, loss, liability, damage, or cost which may

incur as the result of such claim.

AND I, THE MINOR’S PARENT AND/OR LEGAL GUARDIAN, UNDERSTAND THE NATURE OF SKATEBOARD

ACTIVITIES AND THE MINOR’S EXPERIENCE AND CAPABILITIES AND BELIEVE THE MINOR TO BE QUALIFIED,

IN GOOD HEALTH, AND IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN SUCH ACTIVITY. I HEREBY

RELEASE, DISCHARGE, COVENANT NOT TO SUE, AND AGREE TO INDEMNIFY AND SAVE AND HOLD

HARMLESS EACH OF THE RELEASEES FROM ALL LIABILITY CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON

THE MINOR’S ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE

OF THE RELEASEES OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATION AND FURTHER AGREE

THAT IF, DESPITE THIS RELEASE, I, THE MINOR, OR ANYONE ON THE MINOR’S BEHALF MAKES A CLAIM

AGAINST ANY OF THE RELEASEES NAMED ABOVE, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF

THE RELEASEES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE, OR COST

ANY MAY INCUR AS THE RESULT OF ANY SUCH CLAIM.

PARTICIPANTS NAME: _____________________________________DATE: __________________________

PARENT/GUARD. SIGNATURE:_________________________________PRINT:________________________

ADDRESS: ___________________________________________________________________(Street, Box)

________________________________________________________________(City, Province, Postal code)

PHONE: _________________________________

WITNESS SIGNATURE:_________________________________PRINT:______________________________