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HOLLYWOOD CURLING
MINOR PARTICIPANT RELEASE

The undersigned, being a parent or legal guardian of the minor curler (“Minor”) indicated below, hereby makes the following representations: (i) that the undersigned is legally responsible for the Minor and legally empowered to act for, on behalf of, and to execute this Participant Release and thereby bind the Minor; (ii) that the Minor will comply with the rules and regulations of the Releasees (as defined below); (iii) that the undersigned understands that the sport of curling is played on ice and requires physical fitness; (iv) that the Minor possesses such physical fitness; and (v) that the undersigned understands that the risks of the Minor participating in any curling activity could involve serious injury or death.

 In consideration of the Minor being allowed access to the Ice Facility (as defined below) as a participant in any curling activity in the Ice Facility, I, the undersigned, for the Minor and the Minor’s estate, successors, heirs, beneficiaries, administrators, trustees, representatives, and attorneys do hereby remise, release, acquit, and forever discharge (i) Hollywood Curling, a California Nonprofit Corporation (the “Club”); (ii) the United States Curling Association, Inc. (“USCA”); (iii) the Mountain Pacific Curling Association (“MoPac”); (iv) the respective successors and assigns or each of the Club, USCA, and MoPac and (v) the respective employees, officers, and directors, but only while acting in their capacity as such, of each of the Club, USCA, and MoPac (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 the Minor while participating in any curling activity in the Ice Facility 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 the Minor or the Minor’s 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 Facility, or (c) against any other person or entity other than a Releasee.

The Ice Facility shall mean the facility and ice surface in which the sport of curling is played in any of the following locations:

  • Ice Station Valencia, 27745 Smyth Dr, Valencia, CA 91355
  • Pasadena Ice Skating Center, 300 E Green St, Pasadena, CA 91101
  • Promenade Ice Chalet, 550 Deep Valley Dr #107, Rolling Hills Estates, CA 90274
  • The Rink in Downtown Burbank, 150 N 3rd St, Burbank, CA 91502
  • Holiday Ice Rink, 532 S Olive St, Los Angeles, CA 90013
  • Valley Children’s Ice Center of Bakersfield, 1325 Q St #100, Bakersfield, CA 93301

The Expiration Date shall mean the date which is one (1) calendar year after the date this Release is executed below.

In the case that the Minor requires urgent medical attention and I cannot be reached, I hereby authorize (i) emergency personnel and medical practitioners selected by any of the Releasees or other chaperone of the Minor, in their reasonable judgment and sole discretion, to take any and all necessary measures on behalf of the Minor and (ii) the disclosure of the information set forth below to emergency personnel and medical practitioners by any of the Releasees or other chaperone of the Minor.

 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.

Today's date: December 10, 2019

Please select who will be participating...
Minor
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First Participant's Name

First Name*

Middle Name

Last Name*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Parent or Guardian's Email Address

Email*

Confirm Email*
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Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Medical Information for Minors

This information is required if Parent/Guardian will be leaving Minor unattended during the event.


Medical Insurance Carrier

Insurance Policy/Group Number

Allergies, medical conditions, current 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.
Parent or Guardian's Name

First Name*

Middle Name

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