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Parkour Visions general program participation waiver

I, the undersigned (the “Participant”) hereby voluntarily request to participate in Parkour Visions indoor and outdoor classes, workshops, and educational events (hereinafter “class(es)”).

  1. I am familiar with the concept of Parkour and the physical demands involved, which include running, climbing, jumping, vaulting, and other strenuous actions sometimes involving height, speed, and unpredictable surfaces. I understand that Parkour is a high-impact, full-body activity which requires intense focus, awareness of my body’s strengths and limitations, awareness of the environment around me, and extreme caution at all times. I understand that I must exercise good judgment at all times in order to remain safe, including stopping immediately if I feel lightheaded, faint, weak, or in pain. If at any time I feel I cannot continue to participate safely for any reason, whether because of a physical condition, the actions of myself or others, or any other reason, I must immediately discontinue involvement and do not depend or rely on the direction of the event coordinator, affiliated or contracted parties to do so. As with any strenuous physical activity, I am aware that I must take any and all necessary precautions, including but not limited to seeking advice from my physician, prior to taking part in classes.
  2. I understand and acknowledge that participation in Class may involve risk of serious injury or death, including injuries which may result not only from my own actions, inactions, or negligence, but also from the actions, inactions, or negligence of others, the condition of the facilities, equipment, or areas where the Classes are conducted, and/or the physically strenuous nature of Parkour. I or my Parent or Guardian, where applicable, warrant and promise that I assume full responsibility for my conduct and safety at all times, whether or not in actual participation and/or at the Class site.
  3. I certify that I am in good health and have no physical condition that would prevent participation in the Class or put me at greater risk for injury. I agree that all activities undertaken at the Class are conducted at my own risk. Furthermore, I agree to use my personal medical insurance as primary medical coverage payment, if accident or injury occurs, without seeking any recoveries from Releases or Releases insurers. I consent to emergency medical treatment in the event such care is required. Knowing and understanding the risks involved with participation in the Class, I hereby voluntarily and willingly assume responsibility for all risks and dangers associated with my participation in the Class.
  4. In consideration of my participation in the activity, I hereby waive all claims or causes of action against The Pacific Northwest Parkour Association, DBA Parkour Visions, its administrators, directors, agents, officers, volunteers, and employees, other participants, sponsors, advertisers, and if applicable, owners and lessors of the premises on which the Class(es) take place (collectively and hereinafter "Releasees"). I agree and covenant to indemnify and hold harmless Releasees from all liability, claims, demands, losses, or damages on my account, whether caused or alleged to be caused in whole or in part by the negligence of the Releasees or otherwise, and agree that if, despite this release, waiver of liability, and assumptions of risk I, or anyone on my behalf, makes a claim against any of the Releasees, I will indemnify, save and hold harmless each of the Releasees from any loss, liability, damage, litigation expense, attorney fees or costs they may incur as the result of such a claim.
  5. From time to time, Parkour Visions may take photos, videos, or create other visual/audio media of participants. Creating and sharing media helps us make parkour more accessible by showcasing what parkour looks like for different people, and it may help us apply for additional funding for our programs. Uses of visual or audio media may include education, marketing, and other public media, and the participant may be identifiable in such media. If you would like to opt out, please enter this URL in your browser and fill out this form: http://parkourvisions.org/mediaform

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 can be extremely contagious. The main way the virus spreads is from person-to-person through respiratory droplets when people cough, sneeze, or talk. It may also spread by contact with contaminated surfaces and objects. individuals can be infected and show no symptoms and therefore spread the disease. COVID-19 can cause serious and potentially life threatening illness and even death.

Parkour Visions cannot prevent you [or your child(ren)] from becoming exposed to, contracting, or spreading COVID-19 while visiting Parkour Visions’s programs, services, or premises. It is not possible to prevent against the presence of the disease. Therefore, if you choose to utilize Parkour Visions’s services and programs and/or enter onto Parkour Visions’s premises you may be exposing yourself to and/or increasing your risk of contracting or spreading COVID-19.


ASSUMPTION OF RISK: I have read and understood the above warning concerning COVID-19. I hereby choose to accept the risk of contracting COVID-19 for myself and/or my children in order to utilize Parkour Visions’s services and programs and enter sites being used for program or service delivery. These services are of such value to me [and/or to my children,] that I accept the risk of being exposed to, contracting, and/or spreading COVID-19 in order to utilize Parkour Visions’s services and programs and premises in person [if applicable: “rather than arranging for an alternative method of enjoying the same services virtually (e.g. videoconference)].


WAIVER OF LAWSUIT/LIABILITY: I hereby forever release and waive my right to bring suit against Parkour Visions and its owners, officers, directors, managers, officials, trustees, agents, employees, volunteers, partners, or other representatives in connection with exposure, infection, and/or spread of COVID-19 related to utilizing Parkour Visions’s services, programs, and premises. I understand that this waiver means I give up my right to bring any claims including for personal injuries, death, disease or property losses, or any other loss, including but not limited to claims of negligence and give up any claim I may have to seek damages, whether known or unknown, foreseen or unforeseen.


I HAVE CAREFULLY READ AND FULLY UNDERSTAND ALL PROVISIONS OF THIS RELEASE, AND FREELY AND KNOWINGLY ASSUME THE RISK ASSOCIATED WITH COVID-19.

I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND HOLD HARMLESS AGREEMENT. I FULLY UNDERSTAND ITS TERMS, AND I UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME, AND INTEND MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY THE LAW.

 

November 5, 2024

 

 


First Participant's Name

First Name*

Last Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First 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's Email Address

Email*

Confirm Email*
Please keep me updated on free classes, workshops, and other parkour events.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
The following helps up apply for additional funding for our programs:
What is the race/ethnicity of the person who the waiver is for? Check all that apply. *
Multiracial
Middle Eastern or North African
White
Native Hawaiian/Pacific Islander
Hispanic or Latino/a/x Descent
Black/African-American
Asian/Asian-American
American Indian/Indigenous/Alaska Native
European/European Descent
Prefer not to answer
What is the gender of the person who the waiver is for? Check all that apply. *
Male
Female
Trans
Genderfluid
Genderqueer
Nonbinary
Intersex
Other
Prefer not to answer
Is the person who the waiver is for any of the following? Check all that apply. *
Person experiencing poverty
Bi/multilingual
Refugee and/or immigrant
English language learner
Person experiencing homelessness
Youth in foster or kinship care
LGBTQIA+
Person with disabilities, including physical, developmental, and/or intellectual disabilities; or special health care needs
Youth participating in free/reduced cost breakfast/lunch at school
Student using parkour class for PE credits
Veteran
None of the above
Prefer not to answer
Which location are you signing this waiver for?
Seattle area
Portland area
How did you hear about us? (Check all that apply) *
Internet search
From a friend
From your school
At an event
Facebook
Instagram
Youtube
ParentMap
pdxParent
6crickets
Another organization
Other
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*

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
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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