Loading...

CUGA Waiver - Adult

DECLARATION AND COMMITMENT OF THE PARTICIPANT

Assumption of Risks

I am aware of the nature of underwater hockey, underwater rugby and finswimming and the type of events which are organized by the Canadian Underwater Games Association (CUGA) and its associated clubs, which involve certain dangerous conditions.

I therefore acknowledge and accept that in taking part in the activities, I expose myself to risks of serious injuries or even death.

I acknowledge and accept that I am fully aware of those serious risks and dangers and, notwithstanding said knowledge, I have elected to participate in underwater hockey, underwater rugby, and/or finswimming.


CUGA Code Of Conduct    *** NEW ***

CUGA is committed to advancing a sports environment and culture that is respectful, inclusive, and supportive of club and player development. All participants can expect to play, practice, compete, and interact in a safe environment.

I acknowledge and accept the terms and conditions of the Code of Conduct, and as a member of CUGA, will abide by them. 


Waiver of Recourse for Property Damage

In addition to assuming the risks, I hereby waive any recourse for property damage that I may sustain during my participation in one or several of the activities sanctioned by the Canadian Underwater Games Association (CUGA) regardless of whether said property damages are caused by an accident, through the fault or negligence of a third party or the Club. The present waiver inures to the benefit of the Canadian Underwater Games Association (CUGA), its executive, directors, volunteers, members, as well as the promoters, participants, event and facility operators and owners, officials, rescue personnel, sponsors, or any other person or organization having participated in the production of the activity, its setting up or its promotion.

I HAVE SIGNED THIS DECLARATION FREELY AND KNOWINGLY.





First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information
Please select which sport your primarily play*
Please choose which city / club you primarily play with on a regular basis and is considered your Home Club. If your Home Club is not listed choose Other from the dropdown and then fill in the text box with your club name.*

Please fill in this box ONLY if your club is not listed in the dropdown choices above.
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Information
Please select which sport your primarily play*
Please choose which city / club you primarily play with on a regular basis and is considered your Home Club. If your Home Club is not listed choose Other from the dropdown and then fill in the text box with your club name.*

Please fill in this box ONLY if your club is not listed in the dropdown choices above.
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Information
Please select which sport your primarily play*
Please choose which city / club you primarily play with on a regular basis and is considered your Home Club. If your Home Club is not listed choose Other from the dropdown and then fill in the text box with your club name.*

Please fill in this box ONLY if your club is not listed in the dropdown choices above.
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information
Please select which sport your primarily play*
Please choose which city / club you primarily play with on a regular basis and is considered your Home Club. If your Home Club is not listed choose Other from the dropdown and then fill in the text box with your club name.*

Please fill in this box ONLY if your club is not listed in the dropdown choices above.
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information
Please select which sport your primarily play*
Please choose which city / club you primarily play with on a regular basis and is considered your Home Club. If your Home Club is not listed choose Other from the dropdown and then fill in the text box with your club name.*

Please fill in this box ONLY if your club is not listed in the dropdown choices above.
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information
Please select which sport your primarily play*
Please choose which city / club you primarily play with on a regular basis and is considered your Home Club. If your Home Club is not listed choose Other from the dropdown and then fill in the text box with your club name.*

Please fill in this box ONLY if your club is not listed in the dropdown choices above.
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information
Please select which sport your primarily play*
Please choose which city / club you primarily play with on a regular basis and is considered your Home Club. If your Home Club is not listed choose Other from the dropdown and then fill in the text box with your club name.*

Please fill in this box ONLY if your club is not listed in the dropdown choices above.
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information
Please select which sport your primarily play*
Please choose which city / club you primarily play with on a regular basis and is considered your Home Club. If your Home Club is not listed choose Other from the dropdown and then fill in the text box with your club name.*

Please fill in this box ONLY if your club is not listed in the dropdown choices above.
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information
Please select which sport your primarily play*
Please choose which city / club you primarily play with on a regular basis and is considered your Home Club. If your Home Club is not listed choose Other from the dropdown and then fill in the text box with your club name.*

Please fill in this box ONLY if your club is not listed in the dropdown choices above.
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information
Please select which sport your primarily play*
Please choose which city / club you primarily play with on a regular basis and is considered your Home Club. If your Home Club is not listed choose Other from the dropdown and then fill in the text box with your club name.*

Please fill in this box ONLY if your club is not listed in the dropdown choices above.
Parent or Guardian's Email Address

Email*

Confirm Email*
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
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*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
Please select which sport your primarily play*
Please choose which city / club you primarily play with on a regular basis and is considered your Home Club. If your Home Club is not listed choose Other from the dropdown and then fill in the text box with your club name.*

Please fill in this box ONLY if your club is not listed in the dropdown choices above.
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!