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WARRANTY AND CONSENT – PLEASE READ BEFORE SIGNING – ADULT 18yrs +

ASSUMPTION OF RISK RELEASE, MEDIA RELEASE AND WAIVER OF LIABILITY INDEMNITY AGREEMENT

 

I,

(athlete name), wish to participate in the cheerleading programs and related events and activities offered by Cheerleading Canada and the Cheer Canada National Team Program (CCNTP)

I WARRANT TO YOU THAT:

1. I am familiar with the risk of serious injury and death which any participant in this programme must assume, and

2. I believe that I am physically, emotionally and mentally able to participate in this programme, and that my equipment is mechanically fit for my use in this programme, and

3. I understand that all applicable rules for participation must be followed and that at all times the sole responsibility for personal safety remains with me, and

4. I will immediately remove myself from participation, and notify the nearest official, if at any time I sense or observe any unusual hazard or unsafe condition or if I feel that I have experienced any deterioration in my physical, emotional or mental fitness for continued participation in the programme.

Permission is granted to use my picture or image in any or all future advertisements, broadcasting, website, social media, and marketing literature or promotional videos for the CCNTP and/or any events sponsored by them.

I UNDERSTAND AND AGREE, on behalf of myself, my heirs, assigns, personal representatives and next of kin, that my participation in this programme and execution of this document constitutes:

  1. an unqualified ASSUMPTION OF ALL RISKS associated with participation in this programme by me even if arising from negligence, or gross negligence, including any compounding or aggravation of injuries caused by negligent rescue operations or procedures, of the programme organizer and any persons associated therewith or participating therein, and
     
  2. a FULL AND FINAL RELEASE AND WAIVER OF LIABILITY of the programme organizer and all persons and organization associated with it and the programme including, without limiting the generality of the foregoing, its officers, directors, officials, agents and/or employees, coaches, administrators, other participants, sponsors, advertisers, owners and/ or lessors of the premises used to conduct the programme, sanctioning bodies, medical or rescue personnel (the RELEASEES), of and from with the respect to all injury, disability, death or loss or damage to person or property whether arising from the negligence, or negligent rescue of or by the foregoing or otherwise, and
     
  3. an UNDERSTANDING NOT TO SUE the RELEASEES for any loss, injury, costs or damages of any form or type, howsoever caused or arising, and whether directly or indirectly from the participation in this program by me, and
     
  4. an AGREEMENT TO INDEMNIFY, and to SAVE and HOLD HARMLESS the RELEASEES, and each of them, from any litigation expense, legal fees, liability, damage, award or cost, of any form or type whatsoever, they may incur due to any claim made against them or any one of them whether the claim is based on the negligence or the gross negligence of the RELEASEES or otherwise.


I HAVE READ THIS DOCUMENT THOROUGHLY.

I UNDERSTAND THAT THE RELEASEES ARE RELYING UPON MY WARRANTIES, ASSUMPTIONS, WAIVER AND RELEASE, UNDERTAKINGS AND AGREEMENTS WHEN ACCEPTING MY MINOR CHILD'S/WARD'S PARTICIPATION IN THIS PROGRAMME.

I UNDERSTAND THAT BY SIGNING THIS DOCUMENT I GIVE UP SUBSTANTIAL LEGAL RIGHTS I AND/ OR MY MINOR CHILD/WARD WOULD OTHERWISE HAVE.

I SIGN THIS DOCUMENT VOLUNTARILY AND WITHOUT INDUCEMENT.

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

Please list above any medication to which you are allergic, or any previous medical conditions that could impair your performance, any current allergies or any medication that are currently being taken: *
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

Please list above any medication to which you are allergic, or any previous medical conditions that could impair your performance, any current allergies or any medication that are currently being taken: *
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Information

Please list above any medication to which you are allergic, or any previous medical conditions that could impair your performance, any current allergies or any medication that are currently being taken: *
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information

Please list above any medication to which you are allergic, or any previous medical conditions that could impair your performance, any current allergies or any medication that are currently being taken: *
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information

Please list above any medication to which you are allergic, or any previous medical conditions that could impair your performance, any current allergies or any medication that are currently being taken: *
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information

Please list above any medication to which you are allergic, or any previous medical conditions that could impair your performance, any current allergies or any medication that are currently being taken: *
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information

Please list above any medication to which you are allergic, or any previous medical conditions that could impair your performance, any current allergies or any medication that are currently being taken: *
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information

Please list above any medication to which you are allergic, or any previous medical conditions that could impair your performance, any current allergies or any medication that are currently being taken: *
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information

Please list above any medication to which you are allergic, or any previous medical conditions that could impair your performance, any current allergies or any medication that are currently being taken: *
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information

Please list above any medication to which you are allergic, or any previous medical conditions that could impair your performance, any current allergies or any medication that are currently being taken: *
Participant's 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 or Guardian's Email Address

Email*

Confirm Email*
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Health Card Number

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Please list below any medication to which you are allergic, or any previous medical conditions that could impair their performance, any current allergies or any medication that are currently being taken:

Please list all medications
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 or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Please list above any medication to which you are allergic, or any previous medical conditions that could impair your performance, any current allergies or any medication that are currently being taken: *
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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