Registration Forms

KIWANIS DRAGON BOAT FESTIVAL OF WATERLOO REGION 
RELEASE, WAIVER AND INDEMNITY FORM

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In consideration for receiving permission to participate in the Kiwanis Dragon Boat Festival of Waterloo Region race competitions and/or practice sessions offered the Festival and/or . Lively Dragon, I, for myself and my heirs, executors, administrators, successors and assigns, HEREBY RELEASE, WAIVE AND FOREVER DISCHARGE Kiwanis Dragon Boat Festival of Waterloo Region, Laurel Creek Conservation Area, Waterloo Region Conservation Authority, the Kitchener/Waterloo Police Service, the Chief of Police, all sponsors of and contributors to the Dragon Boat Challenge, the Kiwanis Club of Elmira Inc., and all their respective directors, members, trustees, agents representatives, officers, sponsors, licensors, servants, employees, contractors, successors and assigns OF AND FROM ALL claims, demands, damages, costs, expenses, actions, and causes of action, whether in law or equity, in respect of death, injury, loss or damage to my person or property HOWSOEVER CAUSED, arising or to arise by reason of my participation in the said event and/or practice sessions, whether as spectator, participant, competitor or otherwise, whether prior to, during or subsequent to the event or any practice session, AND NOTWITHSTANDING that same may have been contributed to, or occasioned by, the negligence of any of the aforesaid.

I FURTHER HEREBY UNDERTAKE TO HOLD AND SAVE HARMLESS AND AGREE TO INDEMNIFY all of the aforesaid from and against any and all liability incurred by all of them as a result of, or in any way connected with, my participation in the said event and/or practice sessions.

I and my next of kin are duly aware of the risks and hazards inherent in the sport of dragon boat racing and I acknowledge that conditions may be hazardous and dangerous and that obstructions may exist, and that high winds may cause rough water, and I hereby voluntarily assume all risks of loss, damage, or injury, including death, that may be sustained by me or to any property in connection with my participation in the event and/or practice sessions.

I hereby acknowledge and represent, that I have read the foregoing release, understand it and agree to it voluntarily, that I am 18 years of age or older, or will be 10,11,12,13,14,15,16,17 or 18 years of age prior to December 31 of this year and I have co-signed with a parent or guardian, as the case may be.

Team Name:__________________________________________________

Paddler's Name:____________________________________________________________________

Tel: (_____)____________ Fax: (_____)____________ e-mail:_____________________

Contact in case of emergency: _____________________ Tel:______________________

______________           __________________________________________________
Date (m/d/y)                 Signature of Team Member

                                 __________________________________________________
                                 Signature of Parent or Guardian (if under 18 years of age)