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ADULT PARTICIPANT RELEASE

     The undersigned hereby makes the following representations: (i) that the undersigned understands that the sport of curling is played on ice and requires physical fitness; (ii) that the undersigned possesses such physical fitness; and (iii) that the undersigned understands that the risks of participating in any curling activity could involve serious injury or death.

     In consideration of being allowed access to the Ice House (as defined below) as a participant in any curling activity in the Ice House, I, the undersigned, for myself and my estate, successors, heirs, beneficiaries, administrators, trustees, representatives, and attorneys do hereby remise, release, acquit, and forever discharge (i) Cincinnati Curling Club, a Ohio 501c3 NONPROFIT CORPORATION (the “Club”); (ii) the United States Curling Association, Inc. (“USCA”); (iii) the Great Lakes Curling Assocation (“GLCA”); (iv) the respective successors and assigns or each of the Club, USCA, and MARTINI ON ICE, LLC dba SPORTS PLUS and CITY OF BLUE ASH (the “Arena(s)”) and (v) the respective employees, officers, and directors, but only while acting in their capacity as such, of each of the Club, USCA, and the Arena(s) (collectively, the “Releasees”) from any and all actions, causes of action, claims, demands, and liabilities, both in law and equity for damages and any court costs and legal expenses and fees associated therewith in respect of physical, mental, and bodily injury occurring to me while participating in any curling activity in the Ice House prior to the Expiration Date (as defined below); provided, however, that in the event such injury was caused, in whole or in part, by the willful, intentional, reckless, or grossly negligent action or failure to take action of any Releasee, such Releasee shall not be so remised, released, acquitted, or discharged hereby; and provided, further, that nothing herein shall be deemed to limit or exclude any action, cause of action, claim, demand, liability, payment, reimbursement, other benefit, or any court costs or legal expenses and fees that I or my estate, successors, heirs, beneficiaries, administrators, trustees, representatives, or attorneys might have or seek against (a) the Club’s “Participant Medical Accident” insurance coverage, (b) any other participant participating in any curling activity in the Ice House, or (c) against any other person or entity other than a Releasee.

    The Ice House shall mean the arena building(s) containing the ice rink(s) in which the sport of curling is played located at 10765 Reading Road, Cincinnati, OH, and at Summit Park in Blue Ash, 4335 Glendale Milford Rd, Blue Ash, OH, 45242, owned and operated by the Arena(s). The Expiration Date shall mean the date which is one (1) calendar year after the date this Release is executed below.

    I certify that I am at least eighteen (18) years of age and have the legal capacity to execute this Participant Release on my own behalf.

    I hereby revoke any and all releases of liability, waivers, and indemnifications previously executed by me in favor of any of the Releasees.

    BEFORE SIGNING BELOW, I WAS GIVEN THE OPPORTUNITY TO READ THIS PARTICIPANT RELEASE AND TO CONSULT WITH AN ATTORNEY AS TO ITS SIGNIFICANCE.  BY SIGNING BELOW, I UNDERSTAND THAT I AM WAIVING SIGNIFICANT RIGHTS.  I UNDERSTAND THE MEANING OF THIS PARTICIPANT RELEASE AND THE RIGHTS I AM WAIVING.  NOTWITHSTANDING THE FOREGOING, I HAVE CHOSEN, OF MY OWN FREE WILL, TO EXECUTE THIS PARTICIPANT RELEASE.


Date: December 11, 2018

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Information

Please enter your information below. Each person who will be out on the ice will fill out a separate waiver.

If you are registered for your event as a part of a group (for example, a friend signed you both up for spots in our LTC class online using one registration), what name is the registration under?


Name of your group

Your Information


Address 1:

Address 2:

City

State

Zip
First Participant's Signature*
Second Participant's Name

First Name*

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

Please enter your information below. Each person who will be out on the ice will fill out a separate waiver.

If you are registered for your event as a part of a group (for example, a friend signed you both up for spots in our LTC class online using one registration), what name is the registration under?


Name of your group

Your Information


Address 1:

Address 2:

City

State

Zip
Third Participant's Name

First Name*

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

Please enter your information below. Each person who will be out on the ice will fill out a separate waiver.

If you are registered for your event as a part of a group (for example, a friend signed you both up for spots in our LTC class online using one registration), what name is the registration under?


Name of your group

Your Information


Address 1:

Address 2:

City

State

Zip
Fourth Participant's Name

First Name*

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

Please enter your information below. Each person who will be out on the ice will fill out a separate waiver.

If you are registered for your event as a part of a group (for example, a friend signed you both up for spots in our LTC class online using one registration), what name is the registration under?


Name of your group

Your Information


Address 1:

Address 2:

City

State

Zip
Fifth Participant's Name

First Name*

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

Please enter your information below. Each person who will be out on the ice will fill out a separate waiver.

If you are registered for your event as a part of a group (for example, a friend signed you both up for spots in our LTC class online using one registration), what name is the registration under?


Name of your group

Your Information


Address 1:

Address 2:

City

State

Zip
Sixth Participant's Name

First Name*

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

Please enter your information below. Each person who will be out on the ice will fill out a separate waiver.

If you are registered for your event as a part of a group (for example, a friend signed you both up for spots in our LTC class online using one registration), what name is the registration under?


Name of your group

Your Information


Address 1:

Address 2:

City

State

Zip
Seventh Participant's Name

First Name*

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

Please enter your information below. Each person who will be out on the ice will fill out a separate waiver.

If you are registered for your event as a part of a group (for example, a friend signed you both up for spots in our LTC class online using one registration), what name is the registration under?


Name of your group

Your Information


Address 1:

Address 2:

City

State

Zip
Eighth Participant's Name

First Name*

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

Please enter your information below. Each person who will be out on the ice will fill out a separate waiver.

If you are registered for your event as a part of a group (for example, a friend signed you both up for spots in our LTC class online using one registration), what name is the registration under?


Name of your group

Your Information


Address 1:

Address 2:

City

State

Zip
Ninth Participant's Name

First Name*

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

Please enter your information below. Each person who will be out on the ice will fill out a separate waiver.

If you are registered for your event as a part of a group (for example, a friend signed you both up for spots in our LTC class online using one registration), what name is the registration under?


Name of your group

Your Information


Address 1:

Address 2:

City

State

Zip
Tenth Participant's Name

First Name*

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

Please enter your information below. Each person who will be out on the ice will fill out a separate waiver.

If you are registered for your event as a part of a group (for example, a friend signed you both up for spots in our LTC class online using one registration), what name is the registration under?


Name of your group

Your Information


Address 1:

Address 2:

City

State

Zip
Parent or Guardian's Email Address

Email
Cincinnati Curling Club communicates mainly by email. By checking the box, you will be added to our email list and receive information about upcoming events such as learn to curl classes and leagues by e-mail. You can unsubscribe at any time. If you do not opt in, you may receive communication about your upcoming event, but will not be added to our mailing list. If you are already subscribed, your status will not change.
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*
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*

Phone*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information

Please enter your information below. Each person who will be out on the ice will fill out a separate waiver.

If you are registered for your event as a part of a group (for example, a friend signed you both up for spots in our LTC class online using one registration), what name is the registration under?


Name of your group

Your Information


Address 1:

Address 2:

City

State

Zip
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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