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ASSUMPTION OF RISK, WAIVER OF CLAIMS, AND RELEASE OF LIABILITY AGREEMENT (“Release Agreement”)  

BY SIGNING THIS DOCUMENT, YOU WILL WAIVE CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE OR CLAIM COMPENSATION FOLLOWING AN ACCIDENT.  

This is a binding legal agreement.
Please clarify any questions or concerns before signing.  

If the signor is a parent or guardian of the Participant, please educate the Participant on all elements, including risks, dangers, and hazards, before completing this form. All Participants are required to assume such knowledge in this Agreement.  

Definitions  

"Activity" or "Activities" shall include all orientation, training, instruction, supervision, competitions, programs, services, and use of facilities and equipment which are organized, provided, controlled, or conducted by CSI Pacific and its affiliated organizations. 

"Canadian Sport Institute (CSI Pacific)" refers to collectively to any of CSI Pacific’s present and future officers, members, directors, employees, coaches, volunteers, servants, agents, affiliates, independent contractors, owners/operators of the facility in which the Activities take place (collectively CSI Pacific). 

"Participant" refers to the individual Athlete, Coach, or Official (as named in this document).  

Risks  

The Participant fully understands and acknowledges that there are inherent risks, hazards, and dangers associated with all Activities and that no amount of care, caution, or expertise can eliminate, including without limitation, the potential for serious bodily injury, including mental injury, permanent disability, paralysis, dismemberment, and death. These risks (collectively the "Risks") include: 

1.      Health: executing strenuous and demanding physical techniques; physical exertion; over exertion; stretching; dehydration; fatigue' cardiovascular workouts; rapid movements and stops; lack of fitness or conditioning; traumatic injury; sprains and fractures; spinal cord injuries; bacterial infections; rashes; and the transmission of communicable diseases including viruses of all kinds, COVID-19, bacteria, parasites, or other organisms or any mutation thereof.  

2.      Premises: defective, dangerous, or unsafe condition of the facilities; dangerous, unsafe, or irregular conditions; and travel to and from the premises.  

3.      Use of equipment: mechanical failure of the equipment; negligent design or manufacture of the equipment; the provision of, or the failure by, CSI Pacific to provide any warnings, directions, instructions, or guidance as to the use of the equipment; failure to wear safety or protective equipment; and failure to use or operate equipment within the Participant’s own ability.  

4.      Advice: negligent advice regarding the Activities or touching the Participant for the purposes of teaching or executing skills and or testing procedures. 

5.      Ability: failing to act safely or within the Participant’s own ability or within designated areas.  

6.      Privacy: breach by CSI Pacific of the Participant’s right to protection and privacy of personal information provided to CSI Pacific.  

Terms  

In consideration of CSI Pacific allowing the Participant to participate in the Activities, the Participant accepts the following terms:  

1.      The Participant acknowledges that itis their responsibility to consult a medical health practitioner prior to beginning any training or testing regimen.  

2.      The Participant agrees to comply with the rules and regulations for participation in the Activities and use of equipment.  

3.      The Participant accepts that it is their sole responsibility to assess whether any Activities are too difficult. By commencing an Activity, the Participant acknowledges and accepts the suitability and conditions of the Activity. 

4.      The Participant asserts that their mental and physical condition is appropriate to participate in the Activities. The Participant assumes all risks related to the Participant’s mental and physical condition. 

5.      The Participant agrees that they will only access Activities free from impairment, illness or contagious disease including but not limited to COVID-19.  

6.      The Participant acknowledges by participating in an Activity they may be exposed infectious diseases (e.g. COVID-19 or other infections) and such exposure may result in personal injury, illness, permanent disability, or death.  

7.      CSI Pacific has endorsed the Responsible Coaching Movement and the "Rule of Two", both of which serve to protect minor Participants in potentially vulnerable situations by limiting one-on-one interactions between CSI Pacific and Participants. The Participant acknowledges that exceptions to the Rule of Two may be made for medical emergencies and professional practices (Medical, Nutrition, Counselling, Physiological Testing, etc) that involve Participant consent.  

8.      The Participant will act in accordance with a harassment- and abuse-free environment as outlined by the Universal Code of Conduct for Maltreatment in Sport (UCCMS) and CSI Pacific Policies. The Participant will avoid any conduct or action that disparages CSI Pacific including publishing written or oral statements or remarks that are damaging to the integrity, reputation, or good will of CSI Pacific. The Participant understands that if they do not abide by any provision of this Agreement, all privileges offered by CSI Pacific to the Participant may be terminated. 

9.      The Participant will notify the relevant CSI Pacific of any cancellations in writing or electronically at least 24 hours prior to scheduled appointment, unless due to emergency 

10. That the Participant consents to participate in the Activities and may be informed of the nature of the activity prior to participation.  

Public Health Disclaimer 

The Participant agrees that CSI Pacific has the discretion to cancel or modify the structure of any Activities due to a public health or safety issue. The Participant agrees that CSI Pacific may implement and enforce guidelines for participation that may include adhering to protocols, signing declarations of compliance, or requiring that personal protective equipment be worn by Participants. CSI Pacific has the discretion to remove any Participant who does not comply with any policies or protocols, sign a declaration, or wear personal protective equipment. When required, the Participant is responsible for providing their own personal protective equipment.   

General Liability

The Participant assumes all risks arising out of, associated with, or related to, participation in the Activities and waives all claims that the Participant may have now or in the future against CSI Pacific. The Participant accepts and fully assumes all such risks and possibility of personal injury, death, property damage, expense, and related loss, including loss of income, resulting from participation in the Activities. The Participant forever indemnifies and releases CSI Pacific from any and all liability for any and all claims, demands, actions, damages (including direct, indirect, special and/or consequential), losses, actions, judgments, and costs (including legal fees) (collectively, the “Claims”) which the Participant has or may have in the future, that might arise out of, result from, or relate to, participation in the Activities, even though such Claims may have been caused by any manner whatsoever, including but not limited to, CSI Pacific’s negligence, gross negligence, negligent rescue, omissions, carelessness, breach of contract and/or breach of any statutory duty of care of CSI Pacific.  

Governing Law  

This Agreement shall be governed by and is to be interpreted, construed, and enforced in accordance with the laws of the Province of British Columbia and the federal laws of Canada applicable therein.  

Electronic Signature

Consent

By signing below, 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 initialing below, you are waiving that right. After consent, you may, upon written request to CSI Pacific, 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 CSI Pacific in writing or by electronic mail that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that CSI Pacific has a current email address in order to contact you regarding any changes, if necessary.

Counterparts and Electronic Delivery  

This Agreement may be executed and delivered in any number of counterparts, which when taken together shall constitute one and the same instrument. Delivery by electronic means of an originally executed signature page to this Agreement is as effective as personal delivery of such signature page.  

Acknowledgement  

The Participant acknowledges that they have had sufficient time to read and understand this Agreement, that they have executed this Agreement voluntarily, and that this Agreement is to be binding upon themselves, their heirs, spouse, children, parents, guardians, next of kin, executors, administrators and legal or personal representatives. The Participant is aware that by signing this Agreement they are voluntarily waiving certain legal rights which they or their legal representatives may otherwise have against CSI Pacific. 

Please select who will be participating, if the athlete has a preferred name enter it as first or last (where appropriate).
AdultMinor
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First Athlete Name

First Name*

Last Name*
First Athlete Date of Birth*
First Athlete Signature*
Guardian's Email Address

Email*

Confirm Email*
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Background Information

Participant's Email (if different from above)
Preferred Regional Campus*
CSI Pacific - Vancouver
CSI Pacific - Victoria
CSI Pacific - Whistler
Engage Sport North
Pacific Sport - Columbia Basin
Pacific Sport - Fraser Valley
Pacific Sport - Interior
Pacific Sport - Okanagan
Pacific Sport - Vancouver Island
Unsure
Sport*
Demographic Information
Which gender does the Participant identify as?*
Female
Male
Non-binary
Prefer not to say
Which ethnic origin best describes the Participant? *
African
Caribbean
East Asian
European
Indigenous
Latin, Central, or South American
Middle Eastern
Oceanian
South Asian
Southeast Asian
Prefer not to say
Other
Does the Participant have preferred pronouns? *
He/Him/His
She/Her/Hers
They/Them/Theirs
No preference
Other
Participant Province of Birth*

Participant City of Birth *
Participant Province of Residence*

Participant City of Residence *
Is the Participant currently enrolled in or has completed a post-secondary education or trades program?*
Yes
No

Which college, university, trades, or professional program is the Participant enrolled in or complete?

When did the Participant's program start? (First day of month as approximate start date.)

When does the Participant anticipate graduating/graduate? (First day of month as approximate graduation date.)
Social Media Information

What is the Participant's Instagram handle?

What is the Participant's Twitter handle?

What is the Participant's TikTok handle?
Athlete and Coach Agreement

As an athlete or coach (herein identified as Participant), you are eligible to receive programs, services and benefits that will help you to progress toward your sport-specific goals. This section outlines the conditions and terms for accessing programs, service and benefits of CSI Pacific and regional sport partners.

Privacy Information 


PERSONAL CONTACT INFORMATION: the Participant gives permission to be contacted by electronic mail by CSI Pacific for reasons including services, benefits, or informational opportunities. Where the Participant is under the age of majority, information will be shared with the Participant and legal guardian. *
Yes
No
SOCIAL MEDIA RELEASE: the Participant gives permission to be linked via social media handle to CSI Pacific or Community Partner for reasons including services, benefits, or informational opportunities. *
Yes
No
IMAGE RELEASE: the Participant gives permission for CSI Pacific to use any photo and/or video that they appear in for any reasonable purpose, including for promotional and advertising purposes, online, in print, or other social media platforms. CSI Pacific may edit, alter, or copy images or videos. Images and videos will not be provided or sold to any external agency by CSI Pacific without written and explicit consent from the individual therein. *
Yes
No
DATA USE: the Participant agrees to allow CSI Pacific to share personal information within CSI Pacific and/or with sport partners for the purposes of: service delivery across CSI Pacific expertise areas, anonymous longitudinal research, reporting and improvement of services. Sharing of information may be verbal, in writing, or electronically. All information that is shared is held in the strictest confidence by CSI Pacific. This information may be shared externally when lawfully requested in accordance with National and Provincial privacy legislation. Personal information collected will be visible to CSI Pacific, with the exception of medical data whereby collection and use of information will be specified during medical intake processes. For more detail on the CSI Pacific’s policy and methods of collection, use, and disclosure of personal information please refer to the CSI Pacific Privacy Policy linked below. *
Yes
No

Rules and Regulations 

CONDUCT: the Participant agrees to abide by the rules and regulations of CSI Pacific, FoodStuff, and GymWorks facilities. The Participant will act in accordance with a harassment- and abuse-free environment as outlined by the Universal Code of Conduct for Maltreatment in Sport (UCCMS) and CSI Pacific Policies. The Participant will avoid any conduct or action that disparages CSI Pacific including publishing written or oral statements or remarks that are damaging to the integrity, reputation, or good will of CSI Pacific. The Participant understands that if they do not abide by any provision of this Agreement, all privileges offered by CSI Pacific to the Participant may be terminated. *
Yes
No
ANTI-DOPING: THE Participant shall avoid the use of banned substances, or any prohibited behaviours as outlined by the Canadian Anti-Doping Program. *
Yes
No
COMPLAINTS AND SANCTIONS: the Participant agrees to CSI Pacific’s Complaint, Conflict and Dispute Policy and may report in accordance to this policy. The Participant understands that any breaches to this agreement may result in sanctions outlined in CSI Pacific’s Complaint, Conflict and Dispute Policy *
Yes
No
CANCELLATION POLICY: the Participant will notify the relevant CSI Pacific of any cancellations in writing or electronically at least 24 hours prior to scheduled appointment, unless due to emergency. *
Yes
No
TIME TO REVIEW RELEASE AGREEMENT: the Participant represents and warrants to CSI Pacific that the Participant has had sufficient time to read and understand this Agreement, understands their obligations under this Agreement, and is aware that by signing this Agreement the Participant is voluntarily waiving certain legal rights which they or their legal representatives may otherwise have against CSI Pacific. *
Yes
No

Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 19 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.
Guardian's Name

First Name*

Last Name*

Relationship*

Phone*
Guardian's Date of Birth*
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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