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Shoresports Limited waiver form

Please read and complete all fields below


Shoresports Limited, based at Mudeford Quay, cares for the safe welfare of all participants. We consider Health and Safety to be important for all participants and require you to read and review this statement and waiver form to establish our level of commitment to your health and safety.

By signing this form I will ensure that I, my own children and any children in loco parentis will follow the below instructions and understand the statement and conditions.

Any person making a group booking agrees they have read this statement fully, and have the authority to be bound by them on his/her own behalf and on behalf of the individuals within that group.

Each participant agrees to wear a buoyancy aid at all times on the water, will stay within the designated areas of Christchurch harbour, Stour and Avon rivers, avoiding the run (the harbour entrance at end of Mudeford quay) the nature reserve (marked by yellow buoys), and other specified areas. Each participant will follow the safety instructions given and will ensure that all persons within a group booking are familiar with the above and will seek advice if not. Each participant is aware that wetsuits and helmets are available and that footwear is advised.

All the watersports activities offered by Shoresports Limited are strenuous and hazardous in nature. The activities are outdoors and exposed to the elements. Whilst every effort has been made to limit the risk to users, each participant is aware of the risk they are exposed to during the activities offered, which may in some circumstances, lead to personal injury or death. Each participant understands that Shoresports is not liable for personal injury or death owing to the nature of the sport. Participants in these activities should be aware of, and accept, these risks and be responsible for their own actions and involvement in the activities provided. Knowing this, each participant voluntarily assumes all the risks of participating in the booked session and takes full responsibility for any and all damages, liabilities, losses, or expenses incurred as a result of their participation.

Each participant is fully responsible for their actions whilst using Shoresports facilities and equipment. Shoresports accept no responsibility for the actions of the participant nor the consequences of such actions, nor for any loss or damage to a participants personal property.

By signing this form participants make the decision to take part and must be satisfied that this activity is suitable for them as individuals. Shoresports can not be held responsible for aggravation to illness or injury / illness sustained due to participation in this activity. Participants are recommended to seek advice from their medical practitioner prior to taking part in these activities, and make provisions to ensure their safe participation.

This waiver is valid until the end of the calendar year. I will ensure if any changes in details that I will complete a new waiver.

 I confirm that by signing this I have read and understood the contents of this waiver form and agree to all the statements and conditions stated.




First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 16 years of age or older
First Participant's Information
Do you have any medical conditions that we should know about that you don't feel prevents you from participating, but an adjustment is needed? ie asthama, 'instuctor to carry inhaler' If yes please verbally inform a member of staff at the start of each session to discuss*
No
Yes
Can you swim 50m in light clothing? If answer is no please inform the instructor at each session, so we can advice which areas are within your depth.*
No
Yes
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information
Do you have any medical conditions that we should know about that you don't feel prevents you from participating, but an adjustment is needed? ie asthama, 'instuctor to carry inhaler' If yes please verbally inform a member of staff at the start of each session to discuss*
No
Yes
Can you swim 50m in light clothing? If answer is no please inform the instructor at each session, so we can advice which areas are within your depth.*
No
Yes
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information
Do you have any medical conditions that we should know about that you don't feel prevents you from participating, but an adjustment is needed? ie asthama, 'instuctor to carry inhaler' If yes please verbally inform a member of staff at the start of each session to discuss*
No
Yes
Can you swim 50m in light clothing? If answer is no please inform the instructor at each session, so we can advice which areas are within your depth.*
No
Yes
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information
Do you have any medical conditions that we should know about that you don't feel prevents you from participating, but an adjustment is needed? ie asthama, 'instuctor to carry inhaler' If yes please verbally inform a member of staff at the start of each session to discuss*
No
Yes
Can you swim 50m in light clothing? If answer is no please inform the instructor at each session, so we can advice which areas are within your depth.*
No
Yes
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information
Do you have any medical conditions that we should know about that you don't feel prevents you from participating, but an adjustment is needed? ie asthama, 'instuctor to carry inhaler' If yes please verbally inform a member of staff at the start of each session to discuss*
No
Yes
Can you swim 50m in light clothing? If answer is no please inform the instructor at each session, so we can advice which areas are within your depth.*
No
Yes
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information
Do you have any medical conditions that we should know about that you don't feel prevents you from participating, but an adjustment is needed? ie asthama, 'instuctor to carry inhaler' If yes please verbally inform a member of staff at the start of each session to discuss*
No
Yes
Can you swim 50m in light clothing? If answer is no please inform the instructor at each session, so we can advice which areas are within your depth.*
No
Yes
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information
Do you have any medical conditions that we should know about that you don't feel prevents you from participating, but an adjustment is needed? ie asthama, 'instuctor to carry inhaler' If yes please verbally inform a member of staff at the start of each session to discuss*
No
Yes
Can you swim 50m in light clothing? If answer is no please inform the instructor at each session, so we can advice which areas are within your depth.*
No
Yes
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information
Do you have any medical conditions that we should know about that you don't feel prevents you from participating, but an adjustment is needed? ie asthama, 'instuctor to carry inhaler' If yes please verbally inform a member of staff at the start of each session to discuss*
No
Yes
Can you swim 50m in light clothing? If answer is no please inform the instructor at each session, so we can advice which areas are within your depth.*
No
Yes
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information
Do you have any medical conditions that we should know about that you don't feel prevents you from participating, but an adjustment is needed? ie asthama, 'instuctor to carry inhaler' If yes please verbally inform a member of staff at the start of each session to discuss*
No
Yes
Can you swim 50m in light clothing? If answer is no please inform the instructor at each session, so we can advice which areas are within your depth.*
No
Yes
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information
Do you have any medical conditions that we should know about that you don't feel prevents you from participating, but an adjustment is needed? ie asthama, 'instuctor to carry inhaler' If yes please verbally inform a member of staff at the start of each session to discuss*
No
Yes
Can you swim 50m in light clothing? If answer is no please inform the instructor at each session, so we can advice which areas are within your depth.*
No
Yes
Parent or Guardian's Email Address

Email*
Check to receive news by email
A signed copy of this waiver will be sent to the email address you provide.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Additional required information
Are you happy for any photos that are taken of you and your group (and you will be asked in person to confirm) to be added to social media/used for marketing?*
No
Yes

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What is your home address?
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 16 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Relationship*

Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 16 years of age or older
Parent or Guardian's Information
Do you have any medical conditions that we should know about that you don't feel prevents you from participating, but an adjustment is needed? ie asthama, 'instuctor to carry inhaler' If yes please verbally inform a member of staff at the start of each session to discuss*
No
Yes
Can you swim 50m in light clothing? If answer is no please inform the instructor at each session, so we can advice which areas are within your depth.*
No
Yes
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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