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DragonSports Outrigger Canoe and Dragon Boat Participant Screening Questionnaire and Waiver Affirmation

Thank you for participating in the DragonSports USA Outrigger Canoe and/or Dragon Boat programs. With revised guidance for outdoor activities from the CDC, we are able to resume paddling. The guidance is clear that fully vaccinated individuals may participate in outdoor activities without a mask, except in large gatherings. This questionnaire is informed by that guidance, so we ask that you submit this questionnaire ONCE before you paddle on a DragonSports USA outrigger canoe or dragon boat. You will only have to complete this questionnaire once, and if you've already completed the OC-specific questionnaire you DO NOT need to complete this questionnaire again. Thank you, and happy paddling! 

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Screening Information and Affirmation
I have been fully vaccinated against COVID-19 for at least two weeks. *
I agree
I have previously signed a standard DragonSports participation waiver (if not, please visit dragonsports.org/membership for a link to complete the waiver) *
I agree
I have read and agree to comply with the DragonSports USA Supplemental and Temporary Rules for Outrigger Canoes (COVID-19) *
I agree
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Screening Information and Affirmation
I have been fully vaccinated against COVID-19 for at least two weeks. *
I agree
I have previously signed a standard DragonSports participation waiver (if not, please visit dragonsports.org/membership for a link to complete the waiver) *
I agree
I have read and agree to comply with the DragonSports USA Supplemental and Temporary Rules for Outrigger Canoes (COVID-19) *
I agree
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Screening Information and Affirmation
I have been fully vaccinated against COVID-19 for at least two weeks. *
I agree
I have previously signed a standard DragonSports participation waiver (if not, please visit dragonsports.org/membership for a link to complete the waiver) *
I agree
I have read and agree to comply with the DragonSports USA Supplemental and Temporary Rules for Outrigger Canoes (COVID-19) *
I agree
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Screening Information and Affirmation
I have been fully vaccinated against COVID-19 for at least two weeks. *
I agree
I have previously signed a standard DragonSports participation waiver (if not, please visit dragonsports.org/membership for a link to complete the waiver) *
I agree
I have read and agree to comply with the DragonSports USA Supplemental and Temporary Rules for Outrigger Canoes (COVID-19) *
I agree
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Screening Information and Affirmation
I have been fully vaccinated against COVID-19 for at least two weeks. *
I agree
I have previously signed a standard DragonSports participation waiver (if not, please visit dragonsports.org/membership for a link to complete the waiver) *
I agree
I have read and agree to comply with the DragonSports USA Supplemental and Temporary Rules for Outrigger Canoes (COVID-19) *
I agree
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Screening Information and Affirmation
I have been fully vaccinated against COVID-19 for at least two weeks. *
I agree
I have previously signed a standard DragonSports participation waiver (if not, please visit dragonsports.org/membership for a link to complete the waiver) *
I agree
I have read and agree to comply with the DragonSports USA Supplemental and Temporary Rules for Outrigger Canoes (COVID-19) *
I agree
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Screening Information and Affirmation
I have been fully vaccinated against COVID-19 for at least two weeks. *
I agree
I have previously signed a standard DragonSports participation waiver (if not, please visit dragonsports.org/membership for a link to complete the waiver) *
I agree
I have read and agree to comply with the DragonSports USA Supplemental and Temporary Rules for Outrigger Canoes (COVID-19) *
I agree
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Screening Information and Affirmation
I have been fully vaccinated against COVID-19 for at least two weeks. *
I agree
I have previously signed a standard DragonSports participation waiver (if not, please visit dragonsports.org/membership for a link to complete the waiver) *
I agree
I have read and agree to comply with the DragonSports USA Supplemental and Temporary Rules for Outrigger Canoes (COVID-19) *
I agree
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Screening Information and Affirmation
I have been fully vaccinated against COVID-19 for at least two weeks. *
I agree
I have previously signed a standard DragonSports participation waiver (if not, please visit dragonsports.org/membership for a link to complete the waiver) *
I agree
I have read and agree to comply with the DragonSports USA Supplemental and Temporary Rules for Outrigger Canoes (COVID-19) *
I agree
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Screening Information and Affirmation
I have been fully vaccinated against COVID-19 for at least two weeks. *
I agree
I have previously signed a standard DragonSports participation waiver (if not, please visit dragonsports.org/membership for a link to complete the waiver) *
I agree
I have read and agree to comply with the DragonSports USA Supplemental and Temporary Rules for Outrigger Canoes (COVID-19) *
I agree
Parent or Guardian's Email Address

Email
A signed copy of this waiver will be sent to the email address you provide.
Crew/club/team affiliation
If your crew/club/team is not listed, please contact webmaster@dragonsports.org before completing your waiver.*
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*
I certify that I am 18 years of age or older
Parent or Guardian's Screening Information and Affirmation
I have been fully vaccinated against COVID-19 for at least two weeks. *
I agree
I have previously signed a standard DragonSports participation waiver (if not, please visit dragonsports.org/membership for a link to complete the waiver) *
I agree
I have read and agree to comply with the DragonSports USA Supplemental and Temporary Rules for Outrigger Canoes (COVID-19) *
I agree
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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