Loading...

GENERAL PARTICIPATION CONSENT FORM FOR ADULT SAILING PROGRAMS AND EXCURSIONS

This form MUST be completed and signed before participating in any Team Paradise activity.

 

Participation Agreement:

In consideration of Team Paradise Sailing, Inc. and/or US Sailing Center, all risks and waive all liability in connection with my participation in any program, and in executors, or administrators and my undersigned parent, guardian or aide (if applicable) remise, release, indemnify, acquit and hold harmless and forever discharge Team Paradise Sailing, Inc. and/or US Sailing Center, their directors, employees, and agents, instructors, including volunteers, rescue and support personnel, from any and all liabilities, obligations, damages, claims, causes of action, judgments, costs and charges which I may have or which may be incurred by me for any reason of any occurrence during my travel to and from the event, or during my participation therein, whether resulting from any acts or omissions of any persons, from the operation or condition of facilities or premises, or from acts of God or nature.

The state of Florida does not require adult passengers to be wearing life jackets at all times, although it is recommended as a precautionary measure. Florida child life jacket laws require that all children aged six and under on a recreational water vehicle 26 feet or shorter wear a life jacket at all times. The life jacket should be a USCG-approved type I, II or III PFD. The life jacket should fit the child appropriately.

I hereby agree to comply with all rules and regulations, give my permission for the free use of my name and picture in any media account of the Team Paradise Sailing, Inc. and/or US Sailing Center water sports program or any future public relations or fundraising activity. I also agree to assume liability for all and any damages to Team Paradise Sailing, Inc. and/or US Sailing Center property that is under my control while participating in any Team Paradise Sailing, Inc. and/or US Sailing Center activity.  By visiting Team Paradise Sailing, Inc., and/or the US Sailing Center Miami, you voluntarily assume all risks of exposure to COVID-19.

 May 9, 2024

 

Please select who will be participating...
AdultMinor
Continue
First Participants Name

First Name*

Middle Name

Last Name*

Phone*
First Participants Date of Birth*
First Participants Information
Classification *
Youth
Adult
Disabled
VA
Volunteer
Other
Activity *
Adaptive
VA
Community
Lessons
Charter
Membership
More About You
Amputee/Dysmelia (limb deficiency, limb length difference)
Short Stature (Dwarfism)
Spinal Cord Injury (impaired muscle power/impaired passive range of motion)
Spina Bifida
Blind/Visual Impairment
Cerebral Palsy/TBI/Stroke (hypertonia, ataxia, athetosis)
TBI/Stroke
Intellectual Impairment
Other
None of the Above
Are you currently under Doctor's care?*
No
Yes
Are you prone to startle reflex or seizures?*
No
Yes
Have you ever been diagnosed with PTSD?*
No
Yes
Can you swim?*
No
Yes
First Participants Signature*
Participants Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent/Guardian's Email Address

Email
Check to receive information, news, and discounts by e-mail.
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*
How did you hear about us?

Click to customize text box label
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 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/Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent/Guardian's Date of Birth*
Parent/Guardian's Information
Classification *
Youth
Adult
Disabled
VA
Volunteer
Other
Activity *
Adaptive
VA
Community
Lessons
Charter
Membership
More About You
Amputee/Dysmelia (limb deficiency, limb length difference)
Short Stature (Dwarfism)
Spinal Cord Injury (impaired muscle power/impaired passive range of motion)
Spina Bifida
Blind/Visual Impairment
Cerebral Palsy/TBI/Stroke (hypertonia, ataxia, athetosis)
TBI/Stroke
Intellectual Impairment
Other
None of the Above
Are you currently under Doctor's care?*
No
Yes
Are you prone to startle reflex or seizures?*
No
Yes
Have you ever been diagnosed with PTSD?*
No
Yes
Can you swim?*
No
Yes
Parent/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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!