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WAIVER OF LIABILITY, INFORMED CONSENT, MEDICAL RELEASE AND INDEMNITY AGREEMENT

Muskoka Elite Cheer and Tumbling
110 Clearbrook Trail

Bracebridge, ON. P1L 0A3

 

COPYRIGHT © 2018 MUSKOKA ELITE CHEER AND TUMBLING LTD. ALL RIGHTS RESERVED.

February 22, 2020

The following constitutes a binding agreement and contract between Muskoka Elite Cheer and Tumbling Ltd (defined as Muskoka Elite below) and the undersigned who is parent/guardian of a Participant who is a minor OR who is themselves a Participant eighteen years of age or older. The undersigned hereby waives all liability from, gives informed consent to, grants medical release to, and indemnifies Muskoka Elite and agrees to the following:

Definitions

“Activities.” Including but not limited to cheerleading training, tumbling classes, private lessons, fitness classes, flexibility training, dance, team practice(s), group training, open gym, competition(s), performance(s), public exhibition(s), demonstration(s), and community event(s).

“Participant.” The individual, minor, adult, child, son or daughter whose name is below and who plans to participate in Activities at Muskoka Elite.  

“Releasees.” Muskoka Elite and all its affiliates including coaches, parents, directors, owners, employees, Participants, governing associations, insurance providers, competition providers, and third party service providers including but not limited to choreography companies and camp/instruction organizations.

“Muskoka Elite.” The corporation registered in Ontario, Canada under the name Muskoka Elite Cheer and Tumbling Ltd.

Emergency Medical Authorization                    

In emergencies, I hereby grant Muskoka Elite permission to call the appropriate emergency medical services as required including paramedic services. I give permission for Muskoka Elite to seek medical assistance where required in any circumstances it deems necessary and appropriate. I understand Muskoka Elite will make a reasonable effort to contact me in the event of an emergency. I understand that Muskoka Elite is not liable for any losses or costs arising from a emergencies including but not limited to the costs of emergency medical services and agree to pay the costs arising from emergency transportation and/or treatment of the Participant. Moreover, I hereby authorize basic first aid and CPR to be delivered to the Participant by the Muskoka Elite staff and/or coaches. I acknowledge and understand that Muskoka Elite neither warrants nor assumes liability of any kind in relation to administration of basic first aid or CPR.

Fees & Charges                    

I agree to pay all fees incurred by or on behalf of the Participant, including but not limited to registration fees, class fees, late payment charges, competition entry fees, travel expenses, merchandise costs. I understand that Muskoka Elite may at its discretion commence proceedings or engage a debt collector to recover fees outstanding for a period in excess of sixty (60) days. I understand and agree to pay the costs and/or losses related to debt recovery.                                       

Privacy & Personal Information                    

I authorize Muskoka Elite to collect and use my personal information in accordance with The Freedom of Information and Protection of Privacy Act of Ontario and the The Personal Information Protection and Electronic Documents Act of Canada. I consent for coaches and staff at Muskoka Elite to access my personal information. I understand that my personal contact information may be used for matters specifically related to participation in all star cheerleading including to register the Participant with authorized competition companies, governing organizations, insurance providers, parents’ association for fundraising and related communications, Team Moms, and authorized representatives of Muskoka Elite.

Photo & Video                    

I understand and acknowledge that Muskoka Elite is authorized to capture photographs, video recordings, and other likenesses of the Participant for use in newsletters, promotional material, website, social media platforms and other media for publication. I understand and acknowledge that Muskoka Elite owns all rights, titles and interests of such media, photography, videos, and likenesses and I hereby waive any right to ownership and/or compensation thereto. Special requests to cease use of a given photograph, video, or likeness may be sent in writing to info@muskokaelite.com.

Assumption of Risk                    

I acknowledge that participation in activities at Muskoka Elite including but not limited to cheerleading training, tumbling classes, private lessons, fitness classes, flexibility training, dance, team practices, group training, open gym, competition, performances, public exhibitions, demonstrations, and community events (collectively, the "Activities") carry with them reasonable and inherent risks, dangers and hazards, both known and unknown, that are associated with the unique nature of the sport. I acknowledge that personal harm, illness, and/or injury may be sustained by Participants including serious and/or catastrophic injury and possibly death. I assume all risks, losses, damages, and liability incurred by the Participant resulting from or relating to the Activities.

Waiver of Liability

I hereby agree that I and my heirs, next of kin, successors, assigns, executors, and administrators do fully release, indemnify, and hold harmless Muskoka Elite and all its affiliates including coaches, parents, directors, owners, employees, Participants, governing associations, insurance providers, competition providers, and third party service providers including but not limited to choreography companies and camp/instruction organizations (collectively, the "Releasees") as well as their heirs, successors, next of kin, assigns, executors, and administrators from liability relating to illness and/or injury (minimal, serious, catastrophic and/or death) arising from negligence, loss, and/or expenses arising out of the Activities related to cheerleading.

Participation

I acknowledge that the ACTIVITIES require supervision of a qualified instructor, coach, employee or supervisor. Coaches and instructor may engaging in spotting which involves direct physical contact with the Participant for the purposes of learning and safety. I consent to the same. I acknowledge that the Participant has read and is informed of the gym rules below and agrees to abide by them at all times. I acknowledge that parents and Participants have read and are informed of Muskoka Elite’s policies, available at www.MuskokaElite.com and as published in our annual Program Handbook, and agree to abide by them at all times as a condition of participation at Muskoka Elite. Failure to abide by these rules and policies could result in disciplinary action up to and including dismissal from Muskoka Elite. I acknowledge that the Participant is in good health and proper physical condition to engage in the Activities listed above and I agree to notify Muskoka Elite of any changes in the Participants mental or physical health and agree that such changes may affect the Participant’s participation.

Gym Rules

1. Participants acknowledge the risks of injury associated with cheer and dance will pay careful attention to staff instructions.
2. Only indoor footwear, socks or bare feet are allowed in the gym.
3. The viewing area, change rooms, cubby area and washrooms must be kept clean.
4. Only water is permitted in the gym area. Empty bottles must be put in recycling. Personal water bottles must be removed every day.
5. Athletes must have a coach present before training skills or using any of the apparatus.
6. To avoid injury, a proper warm­ up is required before training. No exceptions.
7. Any injury, acute or chronic pain must be reported to coaching staff.
8. Parents and/or guardians are not allowed on the training or competition floor unless explicitly invited by coaching staff.
9. Hair must be tied back and should not cause distraction during training. Coaches will determine acceptable hairstyles.
10. Jewelry is not allowed. Earrings, rings, necklaces, body piercings, anklets, bracelets and watches are not to be worn.
11. All athletes must wear their designated practice apparel to training.
12. Athletes should refrain from training in the competitive uniforms.
13. Use of the equipment is strictly forbidden without the proper supervision of a qualified SM staff member.
14. Muskoka Elite coaches and staff are responsible for the gym and its activities. Coaches and staff have the authority to refuse or expel participants from the gym if and when they deem necessary.
15. Dangerous, silly, or disrespectful behaviour will not be tolerated at anytime.
16. Open Gym is for ages six and up. Participants six and under are encouraged to attend Daytime Playtime.
17. All accidents or incidents must be reported to a Muskoka Elite staff member immediately.
18. Equipment is to be returned to its place by the user.
19. One athlete at a time on equipment and/or drills. Participants must refrain from trying new skills unless directly supervised by a certified coach.
20. No outside shoes of any kind are allowed in the gym including dress shoes, boots or dirty runners.
21. Clothing should be presentable, tasteful, and family appropriate.
22. No food or drink including gum and candy is allow in the gym. Water is allowed.
23. When and if required, the Supervising Coach will implement the emergency policy and procedures.
24. All equipment including balls, sponges, hoops, skipping ropes, etc should be put away when not in use.
25. Mats and tumbling aides should be in place at all times for safety.
26. Muskoka Elite is a nut-free program. Products containing nuts are not allowed at Muskoka Elite.
27. Siblings of athletes not participating in our programs must remain in the foyer area with a parent/guardian at all times.            
28. Muskoka Elite Cheer and Tumbling is not responsible for any personal items lost or stolen.


 

By signing below, I agree that I am eighteen (18) years old or older and am signing for myself or as the legal parent or guardian of a minor. I understand all of the document’s contents and agree to its provisions in all its parts. I understand that by signing this form I waive certain rights and recourse which I and/or the Participant hold again Muskoka Elite Cheer and Tumbling Ltd.

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
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 Email Address

Email*

Confirm Email*
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 Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian Date of Birth*
Parent or Guardian 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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