Loading...

READ BEFORE SIGNING

There are two sections below. 

Section 1. The parent/guardian shall read the information with their minor. Upon the minor's understanding, the parent/guardian shall initial where specified, and sign where required. 

Section 2. The parent/guardian shall read through the information, initial where specified, and sign where required. 

SECTION 1: MINOR'S ACKNOWLEDGEMENT OF RISKS AND RESPONSIBILITIES

I wish to participate in the program, related events and activities of KINGSTON ELITE ALL-STAR CHEERLEADING INC.

I UNDERSTAND AND AGREE WITH THE FOLLOWING STATEMENTS:

  1. The activities involved in this program can be dangerous. I risk the chance of serious injury or death through my participation.
  2. My parents and I believe that I am physically, emotionally, and mentally able to fully participate in this program and as such have given their unqualified permission for me to take part.
  3. I am familiar with, and will follow, all the applicable rules for participation in this program.
  4. My equipment is mechanically fit and suitable for my use in this program.
  5. I understand that at all times during my participation in this program, I have sole responsibility for my safety.   

  6. If, during the course of my participation in this program:                   (a) I learn or become aware, of a change in my health, physical, emotional or mental condition, or,

    (b) I feel unsafe or threatened for any reason, or,

    (c) I notice anything unsafe about the program.

  7. I understand that online programming (such as webinars, remote conferences, workshops, and online training) may have different foreseeable and unforeseeable risks different than in-person programming.
  8. I understand that Kingston Elite All-Star Cheerleading has put in place preventative measures to reduce the spread of COVID-19; however, Kingston Elite All-Star Cheerleading Inc. cannot guarantee that I will not become infected with COVID-19. Further, I understand that I may be exposed to, or infected by, COVID-19 and such exposure may result in personal injury, illness, permanent disability, or death.

I WILL IMMEDIATELY STOP PARTICIPATING AND INFORM THE NEAREST OFFICIAL.

  1. I am willing to accept all risk of being hurt or killed in this program, both known and unknown, and to take full responsibility for my actions and behaviour. 

I HAVE READ THIS STATEMENT OF RISKS AND RESPONSIBILITIES - I UNDERSTAND AND AGREE WITH WHAT I HAVE READ - AND I CHOOSE TO SIGN IT.     


 

SECTION 2: WARRANTY AND CONSENT OF PARENT/GUARDIAN

ASSUMPTION OF RISK RELEASE AND WAIVER OF LIABILITY INDEMNITY AGREEMENT

IN CONSIDERATION of allowing my minor child/ward to participate in the program, related events and activities of KINGSTON ELITE ALL-STAR CHEERLEADING INC.

I WARRANT TO YOU THAT:

  1. I am a parent/guardian having full legal responsibility for decisions regarding my minor child/ward, and,
  2. I am familiar with the risk of serious injury and death which any participant in this program must assume, and,
  3. I believe that my minor child/ward is physically, emotionally and mentally able to participate in this program, and that their equipment is mechanically fit for their use in this program, and, 
  4. I understand, and will instruct my minor child/ward, that all applicable rules for participation must be followed and that at all times the sole responsibility for personal safety remains with my minor child/ward, and,
  5. I will immediately remove my minor child/ward from participation, and notify the nearest official, if at any time I sense or observe any unusual hazard or unsafe condition or if I feel that my minor child/ward has experienced any deterioration in his/her physical, emotional or mental fitness for continued participation in the program.
  6. I acknowledge that the COVID-19 disease has been declared a worldwide pandemic by the World Health Organization and is extremely contagious. I understand that Kingston Elite All-Star Cheerleading Inc. has put in place preventative measures to reduce the spread of COVID-19; however, Kingston Elite All-Star Cheerleading Inc. cannot guarantee that my minor child/ward will not become infected with COVID-19. I understand that COVID-19 is contagious in nature and my minor child/ward may be exposed to, or infected by, COVID-19 and such exposure to my minor child/ward may result in personal injury, illness, permanent disability, or death.   


I UNDERSTAND AND AGREE that photographs and/or video may be taken by staff of Kingston Elite All-Star Cheerleading Inc. for the purposes of promotions, training, monitoring, and security. By executing this agreement, I allow the Athlete's image to be used for any media purposes including, but not limited to, promotions and advertisements. Kingston Elite All-Star Cheerleading Inc. shall maintain all rights to all media collected.   


I UNDERSTAND AND AGREE, ON BEHALF OF MY MINOR CHILD/WARD, MYSELF, MY HEIRS, ASSIGNS, PERSONAL REPRESENTATIVES AND NEXT OF KIN, THAT MY EXECUTION OF THIS DOCUMENT CONSTITUTES:

  1. an unqualified ASSUMPTION OF ALL RISKS associated with participation in this program by my minor child/ward even if arising from negligence, or gross negligence, including any compounding or aggravation of injuries caused by negligent rescue operations or procedures, of the program organizer and any persons associated therewith or participating therein, and,
  2. a FULL AND FINAL RELEASE AND WAIVER OF LIABILITY of the program organizer and all persons and organizations associated with it and the program including, without limiting the generality of the foregoing, its officers, directors, officials, agents and/or employees, other participants, sponsors, advertisers, owners and/ or lessors of the premises used to conduct the program, sanctioning bodies, medical or rescue personnel (the RELEASEES), of and from with the respect to all injury, disability, death or loss or damage to person or property whether arising from the negligence, or negligent rescue of or by the foregoing or otherwise, and,
  3. an UNDERSTANDING NOT TO SUE the RELEASEES for any loss, injury, costs or damages of any form or type, howsoever caused or arising, and whether directly or indirectly from the participation of my minor child/ward in the program, and,
  4. an AGREEMENT TO INDEMNIFY, and to SAVE and HOLD HARMLESS the RELEASEES, and each of them, from any litigation expense, legal fees, liability, damage, award or cost, of any form or type whatsoever, they may incur due to any claim made against them or any one of them whether the claim is based on the negligence or the gross negligence of the RELEASEES or otherwise.
  5. ​To FOREVER RELEASE AND INDEMNIFY the program from any action related to my becoming exposed to or infected by COVID-19 as a result of, or from, any action, omission or negligence of myself or others, including but not limited to Kingston Elite All-Star Cheerleading Inc.


I HAVE READ THIS DOCUMENT THOROUGHLY.

I UNDERSTAND THAT THE RELEASEES ARE RELYING UPON MY WARRANTIES, ASSUMPTIONS, WAIVER AND RELEASE, UNDERTAKINGS AND AGREEMENTS WHEN ACCEPTING MY MINOR CHILD'S/WARD'S PARTICIPATION IN THIS PROGRAM.

I UNDERSTAND THAT BY SIGNING THIS DOCUMENT I GIVE UP SUBSTANTIAL LEGAL RIGHTS I AND/ OR MY MINOR CHILD/WARD WOULD OTHERWISE HAVE.

I SIGN THIS DOCUMENT VOLUNTARILY AND WITHOUT INDUCEMENT.

October 24, 2020

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*
Parent or Guardian's Email Address

Email*

Confirm Email*
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*

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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!