Waiver Form - Gritty Fitty
AMATEUR ATHLETIC
WAIVER AND RELEASE OF LIABILITY
READ BEFORE SIGNING
WAIVER AND RELEASE OF LIABILITY
READ BEFORE SIGNING
Name of Event: Kansas River Gritty Fitty Date(s)of Event: August 30, 2008
IIn consideration of being allowed to participate in any way in the UNITED STATES CANOE
ASSOCIATION athletic sports program, related events and activities, the undersigned acknowledges,
appreciates, and agrees that:
The risk of injury from the activities involved in this program 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 does exist; and,
I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF
ARISING FROM THE NEGLIGENCE OF THE RELEASEES or other and assume full responsibility
for my participation; and,
I willingly agree to comply with the stated and customary terms and conditions for participation. If,
however, I observe any unusual significant hazard during my presence or participation, I will remove
myself from participation and bring such to the attention of the nearest official immediately; and,
I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY
RELEASE AND HOLD HARMLESS the UNITED STATES CANOE ASSOCIATION, and
Rivermiles, LLC, their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.
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 AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
X_______________________________________DATE SIGNED:____________________
(Participant’s Signature)
X_____________________________________________________________________________
(Participant’s name and address Please print)
FOR PARTICIPANTS OF MINORITY AGE
(UNDER AGE 18 AT THE TIME OF REGISTRATION)
This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and
agree to his/her release as provided above, of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all
liabilities incident to my minor child’s involvement or participation in these programs as provided
above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent
permitted by law.
X___________________________________ _________________ ____________________
(Parent/Guardian Signature) Date Signed (Emergency phone number)
IIn consideration of being allowed to participate in any way in the UNITED STATES CANOE
ASSOCIATION athletic sports program, related events and activities, the undersigned acknowledges,
appreciates, and agrees that:
The risk of injury from the activities involved in this program 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 does exist; and,
I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF
ARISING FROM THE NEGLIGENCE OF THE RELEASEES or other and assume full responsibility
for my participation; and,
I willingly agree to comply with the stated and customary terms and conditions for participation. If,
however, I observe any unusual significant hazard during my presence or participation, I will remove
myself from participation and bring such to the attention of the nearest official immediately; and,
I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY
RELEASE AND HOLD HARMLESS the UNITED STATES CANOE ASSOCIATION, and
Rivermiles, LLC, their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.
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 AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
X_______________________________________DATE SIGNED:____________________
(Participant’s Signature)
X_____________________________________________________________________________
(Participant’s name and address Please print)
FOR PARTICIPANTS OF MINORITY AGE
(UNDER AGE 18 AT THE TIME OF REGISTRATION)
This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and
agree to his/her release as provided above, of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all
liabilities incident to my minor child’s involvement or participation in these programs as provided
above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent
permitted by law.
X___________________________________ _________________ ____________________
(Parent/Guardian Signature) Date Signed (Emergency phone number)