Loading...

AMERICAN CANOE ASSOCIATION MINOR WAIVER & RELEASE OF LIABILITY
READ BEFORE SIGNING

IN CONSIDERATION of being permitted to participate in any way in the American Canoe Association, Inc. sports and recreation program and related activities (“Activities”) I, for myself, my personal representatives, assigns, heirs, and next of kin: 

  1. ACKNOWLEDGE, agree, and represent that I understand the nature of Paddlesports and related Activities and that I am qualified, in good health, in proper physical condition to participate in such Activity and willingly agree to comply with the stated and customary terms and conditions of participation. I further agree and warrant that if at any time I believe conditions to be unsafe, I will immediately discontinue further participation in the Activity. If I decide to leave early and not complete the trip as planned, I assume all risks inherent in my decision to leave.
     
  2. FULLY UNDERSTAND that: (a) Paddlesports and related ACTIVITIES INVOLVE RISKS AND DANGERS OF DAMAGE TO PERSONAL PROPERTY AND SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS, AND DEATH ("RISKS"); (b) these Risks and dangers may be caused by my own actions or inactions, the actions or inactions of others participating in the Activity, the condition in which the Activity takes place, or THE NEGLIGENCE OF THE "RELEASEES" NAMED BELOW; (c) there may be OTHER RISKS AND SOCIAL AND ECONOMIC LOSSES either not known to me or not readily foreseeable at this time; and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I incur as a result of my participation or that of the minor in the Activity.
     
  3. HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE American Canoe Association, Inc., its Paddle America Clubs, affiliated clubs and organizational affiliates, their respective ACA certified instructors, certified instructor trainers, and certified instructor trainer educators, administrators, directors, agents, officers, members, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessors of premises on which the Activity takes place, (each considered one of the "RELEASEES" herein) FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, INJURIES, DAMAGE TO PROPERTY, OR OTHER DAMAGES ON MY ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE "RELEASEES" OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS; AND I FURTHER AGREE that if, despite this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT 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 litigation expenses, attorney fees, loss, liability, damage, or cost which any may incur as the result of such claim.

MINOR PARTICIPANT: I, THE MINOR PARTICIPANT, HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND HAVE SIGNED IT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.

Date: December 26, 2024

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

Minor Email *

AMERICAN CANOE ASSOCIATION MEMBERSHIP FORM 

All minor participants in ACA-insured activities must be ACA members in one of the following categories (choose one):

I am currently an ACA member. My member number appears below.
(Check here if renewing with this form)
1-year ACA Individual Membership $25
1-year ACA Competition Individual $25 (+$45 Competition License if applicable)
ACA Event Membership $ 5 (one activity membership, no member benefits)

ACA # (if any)

Activity Description

Sponsoring Org.

Activity Date
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*

Phone*
Second Participant's Date of Birth*
Second Participant's Information

Minor Email *

AMERICAN CANOE ASSOCIATION MEMBERSHIP FORM 

All minor participants in ACA-insured activities must be ACA members in one of the following categories (choose one):

I am currently an ACA member. My member number appears below.
(Check here if renewing with this form)
1-year ACA Individual Membership $25
1-year ACA Competition Individual $25 (+$45 Competition License if applicable)
ACA Event Membership $ 5 (one activity membership, no member benefits)

ACA # (if any)

Activity Description

Sponsoring Org.

Activity Date
Second Participant's Signature*
Third Participant's Name

First Name*

Last Name*

Phone*
Third Participant's Date of Birth*
Third Participant's Information

Minor Email *

AMERICAN CANOE ASSOCIATION MEMBERSHIP FORM 

All minor participants in ACA-insured activities must be ACA members in one of the following categories (choose one):

I am currently an ACA member. My member number appears below.
(Check here if renewing with this form)
1-year ACA Individual Membership $25
1-year ACA Competition Individual $25 (+$45 Competition License if applicable)
ACA Event Membership $ 5 (one activity membership, no member benefits)

ACA # (if any)

Activity Description

Sponsoring Org.

Activity Date
Third Participant's Signature*
Fourth Participant's Name

First Name*

Last Name*

Phone*
Fourth Participant's Date of Birth*
Fourth Participant's Information

Minor Email *

AMERICAN CANOE ASSOCIATION MEMBERSHIP FORM 

All minor participants in ACA-insured activities must be ACA members in one of the following categories (choose one):

I am currently an ACA member. My member number appears below.
(Check here if renewing with this form)
1-year ACA Individual Membership $25
1-year ACA Competition Individual $25 (+$45 Competition License if applicable)
ACA Event Membership $ 5 (one activity membership, no member benefits)

ACA # (if any)

Activity Description

Sponsoring Org.

Activity Date
Fourth Participant's Signature*
Fifth Participant's Name

First Name*

Last Name*

Phone*
Fifth Participant's Date of Birth*
Fifth Participant's Information

Minor Email *

AMERICAN CANOE ASSOCIATION MEMBERSHIP FORM 

All minor participants in ACA-insured activities must be ACA members in one of the following categories (choose one):

I am currently an ACA member. My member number appears below.
(Check here if renewing with this form)
1-year ACA Individual Membership $25
1-year ACA Competition Individual $25 (+$45 Competition License if applicable)
ACA Event Membership $ 5 (one activity membership, no member benefits)

ACA # (if any)

Activity Description

Sponsoring Org.

Activity Date
Fifth Participant's Signature*
Sixth Participant's Name

First Name*

Last Name*

Phone*
Sixth Participant's Date of Birth*
Sixth Participant's Information

Minor Email *

AMERICAN CANOE ASSOCIATION MEMBERSHIP FORM 

All minor participants in ACA-insured activities must be ACA members in one of the following categories (choose one):

I am currently an ACA member. My member number appears below.
(Check here if renewing with this form)
1-year ACA Individual Membership $25
1-year ACA Competition Individual $25 (+$45 Competition License if applicable)
ACA Event Membership $ 5 (one activity membership, no member benefits)

ACA # (if any)

Activity Description

Sponsoring Org.

Activity Date
Sixth Participant's Signature*
Seventh Participant's Name

First Name*

Last Name*

Phone*
Seventh Participant's Date of Birth*
Seventh Participant's Information

Minor Email *

AMERICAN CANOE ASSOCIATION MEMBERSHIP FORM 

All minor participants in ACA-insured activities must be ACA members in one of the following categories (choose one):

I am currently an ACA member. My member number appears below.
(Check here if renewing with this form)
1-year ACA Individual Membership $25
1-year ACA Competition Individual $25 (+$45 Competition License if applicable)
ACA Event Membership $ 5 (one activity membership, no member benefits)

ACA # (if any)

Activity Description

Sponsoring Org.

Activity Date
Seventh Participant's Signature*
Eighth Participant's Name

First Name*

Last Name*

Phone*
Eighth Participant's Date of Birth*
Eighth Participant's Information

Minor Email *

AMERICAN CANOE ASSOCIATION MEMBERSHIP FORM 

All minor participants in ACA-insured activities must be ACA members in one of the following categories (choose one):

I am currently an ACA member. My member number appears below.
(Check here if renewing with this form)
1-year ACA Individual Membership $25
1-year ACA Competition Individual $25 (+$45 Competition License if applicable)
ACA Event Membership $ 5 (one activity membership, no member benefits)

ACA # (if any)

Activity Description

Sponsoring Org.

Activity Date
Eighth Participant's Signature*
Ninth Participant's Name

First Name*

Last Name*

Phone*
Ninth Participant's Date of Birth*
Ninth Participant's Information

Minor Email *

AMERICAN CANOE ASSOCIATION MEMBERSHIP FORM 

All minor participants in ACA-insured activities must be ACA members in one of the following categories (choose one):

I am currently an ACA member. My member number appears below.
(Check here if renewing with this form)
1-year ACA Individual Membership $25
1-year ACA Competition Individual $25 (+$45 Competition License if applicable)
ACA Event Membership $ 5 (one activity membership, no member benefits)

ACA # (if any)

Activity Description

Sponsoring Org.

Activity Date
Ninth Participant's Signature*
Tenth Participant's Name

First Name*

Last Name*

Phone*
Tenth Participant's Date of Birth*
Tenth Participant's Information

Minor Email *

AMERICAN CANOE ASSOCIATION MEMBERSHIP FORM 

All minor participants in ACA-insured activities must be ACA members in one of the following categories (choose one):

I am currently an ACA member. My member number appears below.
(Check here if renewing with this form)
1-year ACA Individual Membership $25
1-year ACA Competition Individual $25 (+$45 Competition License if applicable)
ACA Event Membership $ 5 (one activity membership, no member benefits)

ACA # (if any)

Activity Description

Sponsoring Org.

Activity Date
Tenth Participant's Signature*
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*
Check to receive information, news, and discounts by e-mail.
Parent/Guardian Info

Parent/Guardian ACA # (if any)

P/G Street Address

P/G City

P/G State

P/G Zip
PARENT OR GUARDIAN: I, THE MINOR'S PARENT AND/OR LEGAL GUARDIAN, UNDERSTAND THE NATURE OF PADDLESPORTS AND RELATED ACTIVITIES AND THE MINOR'S EXPERIENCE AND CAPABILITIES AND BELIEVE THE MINOR TO BE QUALIFIED, IN GOOD HEALTH, AND IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN SUCH ACTIVITY. I HEREBY RELEASE, DISCHARGE, COVENANT NOT TO SUE, AND AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS EACH OF THE RELEASEES FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON THE MINOR'S ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE "RELEASEES" OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS AND FURTHER AGREE THAT IF, DESPITE THIS RELEASE, I, THE MINOR, OR ANYONE ON THE MINOR'S BEHALF MAKES A CLAIM AGAINST ANY OF THE RELEASEES NAMED ABOVE, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE, OR COST ANY MAY INCUR AS THE RESULT OF ANY SUCH CLAIM.


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*

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

Minor Email *

AMERICAN CANOE ASSOCIATION MEMBERSHIP FORM 

All minor participants in ACA-insured activities must be ACA members in one of the following categories (choose one):

I am currently an ACA member. My member number appears below.
(Check here if renewing with this form)
1-year ACA Individual Membership $25
1-year ACA Competition Individual $25 (+$45 Competition License if applicable)
ACA Event Membership $ 5 (one activity membership, no member benefits)

ACA # (if any)

Activity Description

Sponsoring Org.

Activity Date
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!