Event #:__________ Club:___________________________________ Bow #:___________
King's Head Regatta on the Schuylkill
Rowing Release and Waiver of Liability, Assumption
Of Risk and Indemnity Agreement ("Agreement") Also for Minors
IN CONSIDERATION of being given the opportunity to participate in any way in the King's Head Regatta and Upper Merion Boat Club for Competitive and Recreational Rowing Inc. ("Club") activities ("Activity") until the end of this calendar year, I, for myself, my personal representatives, assigns, heirs and next of kin:
I have read this agreement, fully understand its terms, understand that I have given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid the balance, notwithstanding, shall continue in full force and effect.
PARENTAL CONSENT FOR MINOR PARTICIPANTS UNDER THE AGE OF 18 (IS REQUIRED): AND I, the minor's parent and/or legal guardian, understand the nature of rowing activities and the minor's experience and capabilities and believe the minor to be qualified 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 operations, 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 above Releasees, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS each of the Releasees from any litigation expenses, attorney fees, loss liability, damage, or any cost which may incur as a result of such claim. (USE ONE FORM FOR EACH MINOR. If used for Minor, do not use for participants over age 18. ONE COPY OF THIS FORM IS REQUIRED FOR EACH MINOR.)
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Printed Name of Parent/Guardian__________________________________ |
Printed Name of Participant under 18________________________________________ |
Address________________________________________ Phone________________ Date___________
Parent/Guardian Signature (only if participant under the age of 18)_________________________________
Release for all other participants over the age of 18:
|
Printed Name |
Signature |
Date |
|
1. ___________________________ |
________________________________ |
___________ |
|
2. ___________________________ |
________________________________ |
___________ |
|
3. ___________________________ |
________________________________ |
___________ |
|
4. ___________________________ |
________________________________ |
___________ |
|
5. ___________________________ |
________________________________ |
___________ |
|
6. ___________________________ |
________________________________ |
___________ |
|
7. ___________________________ |
________________________________ |
___________ |
|
8. ___________________________ |
________________________________ |
___________ |
|
9. ___________________________ |
________________________________ |
___________ |
Name and address of person to whom all communications regarding this entry shall be directed:
Contact____________________________Phone Day_____________Phone Night__________
Address________________________________________________________
City__________________________State_________ZIP___________
USE ONE FORM FOR EACH EVENT and/or USE ONE FORM FOR EACH MINOR
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