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Cabrillo Beach Yacht Club Junior Sailing Minor Liability Release Form - High School Fall 2018

 

 

I HEREBY ACKNOWLEDGE AND AGREE that the sport of sailing and the use of the facilities and equipment of Cabrillo Beach Yacht Club and Cabrillo BeachYouth Sailing Club (CBYC, CBYSC) and other other training facilities, has inherent risks. I have full knowledge of the nature and extent of all the risks associated with the sport of sailing and the use of boats and facilities.

CBYC and CBYSCclasses are built around the US Sailing philosophy of safety, fun, and learning in that order. Our classes are always conducted with safety as the first consideration. However, sailing is an outdoor, physical activity, and accidents can happen. I understand that during my participation inCBYC / CBYSCsailing classes and other related events, I may be exposed to a variety of hazards and risks, foreseen or unforeseen, which are inherent in sailing and boating and which cannot be eliminated without destroying the unique character of the activity. These inherent risks include, but are not limited to, the dangers of serious personal injury, property damage, and death (Injuries and Damages) from exposure to the hazards of sailing and boating andCBYC/CBYSChas not tried to contradict or minimize my understanding of these risks.

I know that Injuries and Damages can occur by natural causes or activities of other persons or animals, either as a result of negligence or because of other reasons. I understand that risks of such Injuries and Damages are involved in sailing and boating as well as in preparing for, traveling to and returning fromCBYC/ CBYSCactivities and I appreciate that I may have to exercise extra care for my own person and for others around me in the face of such hazards. I further understand that duringCBYC/ CBYSCactivities there will not be professional rescue or medical facilities or expertise provided by CBYC/CBYSCnecessary to deal with the Injuries and Damages to which I may be exposed

I represent that the minor is in good health, is able to undertake sailing activities, and can swim well enough in the event his/her boat capsizes to avoid any resulting danger. I further represent that the minor is capable of comprehending instruction, following directions and observing proper safety precautions. I agree to abide by the decisions of the CBYC/CBYSC Board of Directors if he/she finds it necessary to discipline or dismiss the minor for lack of attention misbehavior or failure to follow safety precautions.

I indicate my understanding that participating in CBYC/CBYSC activities involves risk of injury, and I authorize the staff of Cabrillo Beach Youth Sailing to obtain emergency or medical treatment fortheminorin the event of a medical emergency.

I acknowledge and voluntarily assume the risks of illness, injury, and death associated with these activities, inherent or otherwise, and whether or not they are described above. I hereby waive any liability of CBYC/CBYSC, either organizationally or of any of its officers, agents,representatives or employees, for injuries or damages sustained by me in connection with my participation in CBYC/CBYSC activities. I further waive any claim against CBYC/CBYSC or its officers, employees or agents for injuries (including death) or damages sustained in connection with my participation in any CBYC/CBYSC activities, other than injuries or damages caused by the gross negligence or intentional misconduct ofCBYC/CBYSC or one of its officers, employees or agents.

To the fullest extent permitted by law, I promise not to sue, I forever release and agree to indemnify and hold harmless CBYC/CBYSC from and against any and all claims, damages, liabilities, losses, costsand expenses including attorney fees, for personal injury to the minor or any other person and/or loss of any property, arising from the minor's participation in the sailing program and shore side activities and any active or passive negligence of CBYC/CBYSC, such as negligent rescue.

 

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First Students Name

First Name*

Last Name*

Phone*
First Students Date of Birth*
First Students Information

Students Email Address

Students Cell Phone
School Represented*
High School Graduation Year*

Parent Contact 1 Name, Cell, Email


Parent Contact 2 Name, Cell, Email 

First Students Signature*
Students 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
Check to receive information by e-mail.
A signed copy of this waiver will be sent to the email address you provide.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Insurance

Insurance Carrier*

Insurance Policy Number*
PHOTO RELEASE
I grant permission to Cabrillo Beach Yacht Club (CBYC) and the Cabrillo Beach Youth Sailing Foundation and organizations they are affiliated with to use both mine and my child's likeness(es), photographic image(s) and our name(s) in it's educational, promotional, and publicity communications and materials free of charge. I do not limit this use to conclude at a specific time of date.*
No
Yes
Does minor have any learning disability that might prevent you from fully participating in this course?
Click to customize question*
No
Yes

If yes please specifiy:
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.
Parent or Guardian's Name

First Name*

Last Name*

Relationship*

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

Students Email Address

Students Cell Phone
School Represented*
High School Graduation Year*

Parent Contact 1 Name, Cell, Email


Parent Contact 2 Name, Cell, Email 

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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