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SYC Watersports & Social Activities Release and Assumption of Risks Agreement

Adult - Minors Form   (Rev. 06-2020)

The Parties to the Agreement and Effective Date: This Agreement is made between PEBBLE BEACH COMPANY (PBC), the STILLWATER YACHT CLUB (SYC), and PARTICIPANT, and is to remain in effect for the duration of the PARTICIPANT’S participation in SYC watersports and social activities programs.  Reference to PBC includes "The Beach and Tennis Club".  All references to PBC or SYC also include their holdings, individual companies and properties, affiliates, insurers, officers, directors, employees, agents and representatives, owners and parent companies, partnerships, subsidiaries, and assigns.

The term "PARTICIPANT" as used in this Agreement describes the person who will be participating in the activities described below. If the PARTICIPANT is a minor child under the age of 18, the term “PARTICIPANT” also includes the parent or legal guardian of the minor child PARTICIPANT indicated below.  By signing this Agreement on behalf of the PARTICIPANT minor child the parent or legal guardian indicated below agrees and understands that this Agreement is fully enforceable against the parent or legal guardian and the parent or legal guardian’s minor child PARTICIPANT.  Whether PARTICIPANT describes me, or my minor child, I intend that it also describe and include non-custodial parents, insurers, heirs, and assigns.

The Activities Covered by the Agreement: PARTICIPANT desires to participate in recreational water sport and social activities as part of the SYC seasonal watersports and other social activities, which may entail the use of boats, kayaks paddleboards and other water related equipment belonging to or operated by SYC, and/or its individual members, during the summer Watersports Program season, as well as undertake and receive instruction regarding sailing, boating, kayaking and paddle boarding from SYC, or to participate in any SYC social activities (the “Activities”).  In addition, and in consideration for the agreement by PARTICIPANT, PBC and SYC agree to allow PARTICIPANT access to  their property and facilities for the recreational purpose of participation in the Activities described herein, including other incidental recreational activities which shall also be governed by this Agreement.  PBC and SYC are willing to allow such recreational use and access to their facilities, property, and equipment, as well as provide said instruction, but only in consideration for the PARTICIPANT's agreement to the terms herein, in addition to any other conditions which may be imposed by PBC and/or SYC.

PARTICIPANT’s Agreement to Assume the Risks Associated with the Activities: I understand that there are risks associated with the activities described in this Agreement. Specifically, with regard to boating, kayaking paddle boarding and other water related activities, I understand that there are risks of bodily injury, property damage, and even death, from drowning, hypothermia, and other dangers that are both foreseeable and unforeseeable.

I understand that participation in the Activities also includes possible exposure to and illness from infectious diseases, including, but not limited, to MRSA, influenza, and COVID-19.  PBC and SYC have implemented preventative measures to reduce the spread of infectious diseases.  These include, but are not limited to, screening individuals before they are permitted to enter PBC or SYC facilities, implementing social distancing measures, wellness monitoring, increased sterilization of equipment and premises, and required hand-washing.  However, given the contagious nature of these infectious diseases, including COVID-19, the PBC and SYC cannot guarantee that PARTICIPANTS or their family members will not become infected with infectious diseases like COVID-19.  Further, because PARTICIPANTS and PARTICIPANT’s parents/guardians will be in or near groups of other people, attending the PBC and SYC Activities creates an inherent and unavoidable risk that they will contract infectious diseases like COVID-19.

I am familiar with the Centers for Disease Control and Prevention (“CDC”) guidelines regarding COVID-19.  I acknowledge and understand that the circumstances regarding COVID-19 are changing from day to day and that, accordingly, the CDC guidelines are regularly modified and updated, and I accept full responsibility for familiarizing myself with the most recent updates and following the recommended guidelines to minimize the risk of exposure to and transmission of infectious diseases including COVID-19. 

I willingly agree to comply with the stated and customary terms and conditions for participation, including as these terms and conditions specifically apply to  protection against infectious diseases.  If, however, I observe any unusual or significant hazard during my presence or participation in the Activities, I will remove myself from participation in the Activities and report the actual or suspected hazard to the nearest SYC official immediately.

Moreover, I agree to participate in all Activities described above and VOLUNTARILY ASSUME ALL RISK KNOWN AND UNKNOWN, OF ILLNESS, INJURY, DISABILITY, OR DEATH CAUSED BY infectious diseases like COVID-19, EVEN IF CAUSED IN WHOLE OR IN PART BY THE ACTION, INACTION, OR NEGLIGENCE OF PBC, SYC, or either of their employees, independent contractors, volunteers, or PARTICIPANTS.  I assume full responsibility for any risk of contracting infectious diseases like COVID-19 at PBC and SYC.

With regard to other recreational activities in which I may participate while on PBC property, I also understand that those activities present risks of injury, property damage, or death. PARTICIPANT SPECIFICALLY ACKNOWLEDGES THAT BOATING, SAILING, KAYAKING, PADDLE BOARDING INVOLVES THESE RISKS OF BODILY INJURY, ILLNESS, DISEASE AND DEATH, AND PARTICIPANT IS WILLING TO, AND HEREBY DOES, EXPRESSLY AND VOLUNTARILY ASSUME ALL SUCH RISKS. PARTICIPANT FURTHER ACKNOWLEDGES AND AGREES THAT OTHER RECREATIONAL OR SOCIAL ACTIVITIES INCIDENTAL TO AND ARISING OUT OF THE RECREATIONAL VISIT TO SYC AND PBC PROPERTY MAY ALSO INVOLVE RISK OF BODILY INJURY, ILLNESS, DISEASE, DISABILITY AND/OR DEATH WHICH PARTICIPANT IS ALSO WILLING TO, AND HEREBY DOES, EXPRESSLY AND VOLUNTARILY ASSUME.

My Intention to Release and Discharge, in Advance, PBC and SYC from Any Claims Arising Out of those Risks, Even if They Arise Due to PBC and/or SYC's Negligence: PARTICIPANT, in advance, hereby voluntarily releases, discharges, and agrees to defend, hold harmless, and indemnify PBC and/or SYC from any and all claims, actions, charges, expenses, attorney fees, or causes of action for personal injury, property damage, or death occurring to PARTICIPANT arising from the activities described herein, or incidental to those activities, regardless of whether the same shall arise by the negligence of PBC and/or SYC. PARTICIPANT acknowledges that PBC and/or SYC would not agree or allow participation in the activities, or use and access to its property and facilities, without this agreement. IT IS THE INTENTION OF THIS AGREEMENT TO EXEMPT AND RELIEVE PBC AND SYC FROM LIABILITY FOR PERSONAL INJURY, ILLNESS, INFECTIOUS DISEASE (SUCH AS COVID-19), DISABILITY, PROPERTY DAMAGE, OR WRONGFUL DEATH TO THE FULLEST EXTENT OF THE LAW, EVEN IF CAUSED BY THE NEGLIGENCE OF PBC, SYC, or either of their employees, independent contractors, volunteers, or PARTICIPANTS.  For example, if I contract Covid-19 at PBC or SYC or injure myself while participating in an Activity at PBC or SYC, I will not be able to sue PBC or SYC, and PBC and SYC will not be responsible at all, unless I contract COVID-19 or otherwise injure myself because PBC’s or SYC’s fraud, willful or intentional misconduct, violation of the law, or gross negligence. 

I voluntarily agree to assume known and unknown risks associated with the Activities.

My Agreement that I or My Minor Child Will Wear a Coast Guard-Approved Personal Flotation Device at All Times: PARTICIPANT agrees to wear a Coast Guard approved lifejacket at all times while using any boat, kayak, paddleboard or other flotation device in Stillwater Cove or otherwise participating in water sport activities.

Consent and Authorization for PBC and SYC to Provide Medical and Dental Treatment for my Minor Child: In further consideration for the agreements of PBC and SYC, made herein, I also agree, represent, and warrant that I am the parent or legal guardian of the minor child whose name is listed above and below. I hereby authorize SYC, into whose care the child has been entrusted by me, to consent to any x-ray examination, anesthetic, medical or surgical diagnosis or treatment and hospital care to be rendered to said minor under the general and special supervision and upon the advice of a physician and surgeon licensed under the provisions of the California Medical Practice Act, and also consent to any x-ray examination, anesthetic, dental or surgical diagnosis or treatment, and hospital care to be rendered to said minor by a dentist licensed under the provisions of the California Dental Practice Act.

I understand that this "Consent and Authorization for SYC to Provide Medical and Dental Treatment for my Minor Child" and/or the AUTHORIZATION TO TREAT MINOR that may be attached hereto will be used if SYC or PBC is unable to reach me within a reasonable period of time given the circumstances of the emergency. I, on behalf of myself, my spouse, my dependent(s), heirs, insurers, and other representatives hereby forever release PBC and SYC from any and all liability for exercising that authorization. I am aware that no medical staff and/or medical facilities are available on the premises and, as a result, medical attention from other health care providers shall be requested and obtained in the event of an emergency.

By signing below, I represent that I have carefully read and understand this Agreement. In the event that I am executing this Agreement on behalf of a minor child, I also represent that I have authority to execute and deliver this Agreement for and on behalf of the minor child named below.

Executed on date indicated next to my signature below.

 

AUTHORIZATION TO TREAT MINOR

I am the [parent or parent having legal custody or guardian or caregiver and a relative] of a minor (Minor). Under Family Code Section 6550, I may authorize medical and dental care for the aforementioned child.

I hereby authorize any agent of PEBBLE BEACH COMPANY (PBC), the STILLWATER YACHT CLUB (SYC) to act as my agent to consent to x-ray examination, anesthetic, medical or surgical diagnosis or treatment and hospital care to be rendered to him or her under the general or special supervision of and upon the advice of a physician and/or surgeon licensed under the provisions of the Medical Practice Act or a dentist licensed under the provisions of the Dental Practice Act.

I understand that this authorization is given in advance of any specific diagnosis, treatment or hospital care being required, but it is given to provide authority and power to render care which the aforementioned physician, surgeon or dentist in the exercise of his or her judgment, may deem advisable for the Minor.

Further, I understand the Minor will be participating in a hazardous recreational activity that may result in injury.

I agree to pay for the Minors medical expenses, including the cost of emergency medical services, if he or she is injured. I understand that an effort will be made to contact me prior to rendering treatment, but any of the above treatment or emergency services will not be withheld if I can not be reached.

This consent shall remain in effect until the Minor reaches age 18 (unless revoked at an earlier time).

 

VIDEO-PHOTO RELEASE

I give PEBBLE BEACH COMPANY (PBC) and STILLWATER YACHT CLUB (SYC) permission to make photographs, videotapes, films or other likenesses of me, my child or legal ward. I hereby grant to PBC and SYC the unrestricted right to copyright any of the above-mentioned materials containing images of me, as well as the unrestricted right to use and reuse them, with their caption information , in whole or in part, in any manner, for any purpose and in any medium now known or hereinafter invented. These rights include, but are not limited to, the right to publish, copy, distribute, alter, license and publicly display these materials and images for editorial, trade, marketing and/or advertising purposes, I also grant to SYC and its licensees the unrestricted right to use and disclose my name in connection with use of the above materials.

I understand and agree that I will not be paid for any use described above.

I also waive, and release and discharge SYC, PBC, and their officers, employees and/or agents from, any and all claims arising out of or in connection with any use of the materials, caption information and images described above, including any and all claims for libel, defamation and/or invasion of privacy or publicity. I realize I cannot withdraw my consent after I sign this form and realize this form is binding on me and my heirs, legal representative and assigns.

First Participant's Name

First Name*

Middle Name

Last Name*

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

List medication, allergies and/or other helpful information
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*

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

List medication, allergies and/or other helpful information
Third Participant's Name

First Name*

Middle Name

Last Name*

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

List medication, allergies and/or other helpful information
Fourth Participant's Name

First Name*

Middle Name

Last Name*

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

List medication, allergies and/or other helpful information
Fifth Participant's Name

First Name*

Middle Name

Last Name*

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

List medication, allergies and/or other helpful information
Sixth Participant's Name

First Name*

Middle Name

Last Name*

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

List medication, allergies and/or other helpful information
Seventh Participant's Name

First Name*

Middle Name

Last Name*

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

List medication, allergies and/or other helpful information
Eighth Participant's Name

First Name*

Middle Name

Last Name*

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

List medication, allergies and/or other helpful information
Ninth Participant's Name

First Name*

Middle Name

Last Name*

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

List medication, allergies and/or other helpful information
Tenth Participant's Name

First Name*

Middle Name

Last Name*

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

List medication, allergies and/or other helpful information
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*
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Medical Information

Name of your preferred Physician

Physician's Phone Number
Membership Information
Please select the description below that applies to you:*
Member of Stillwater Yacht Club
Guest of Stillwater Yacht Club Member
Neither

Name of SYC Member Host, if Participant is a Guest
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*

Relationship*

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

List medication, allergies and/or other helpful information
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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