Indicates required field
TEAM NAME (if applicable):
INTERMEDIATE (a few years)
EXPERIENCED (many years, competitive)
VERSATILE / DON'T KNOW / SPARE
I AM A:
REGULAR - $325
STUDENT - $300 (valid Student ID)
SPARE - $35
elect a simple question/answer).
Curling with Pride | PO Box 52011 | 10907 Whyte Ave NW
Edmonton, AB T6G 0S7
be received before Sept. 22; non-payment will result in the cancellation of your registration.
WE WANT TO KNOW...
Are you interested in participating in the Icebreaker Bonspiel Nov. 10-12 (in Edmonton)?
Are you First Aid certified and interested in becoming one of our League's first aid contacts?
Are you interested in curling lessons or clinics?
Are you (or someone you know) interested in donating a prize or being a League sponsor?
NAME OF EMERGENCY CONTACT:
EMERGENCY CONTACT PHONE NUMBER:
RELEASE OF LIABILITY, WAIVER OF CLAIMS
& INDEMNITY AGREEMENT:
All Curling with Pride participants must complete the waiver form prior to curling. Failure to complete the waiver form will result in the cancellation of your membership.
In consideration of approval to participate in the Curling with Pride League, I hereby agree as follows:
(please check each line to indicate your approval).
READ and CHECK EACH LINE:
I agree to waive any and all claims that I have or may in the future have against Curling with Pride, its directors, officers, employees and representatives, game officials, club executives, my team mates, and other players all of whom are hereinafter collectively referred to as "Releasees".
I agree to release the Releasees from any and all liability for any loss, damage, injury or expense that I may suffer or that my next of kin may suffer as a result of my participation in the Curling with Pride League due to any cause whatsoever, including negligence, breach of contract or duty of care.
I agree to hold harmless and indemnify the Releasees from any and all liability for any damage to property of, or personal injury to, or costs, any third party, resulting from my participation in this activity.
I agree that this agreement shall be effective and binding upon my heirs, next of kin, executors, administrators or representatives in the event of my death or incapacity.
READ and CHECK EACH LINE:
I am aware that there is a potential risk for injury involved in the training and participation of any physical activity.
I freely accept and fully assume all such risks, dangers and hazards, including but not limited to injury through physical activity and/or use of equipment and facilities, and the possibility of personal injury, death, property damages or loss, resulting from my participation in the Curling with Pride League.
I am aware that I should discuss my participation in this activity with my physician to determine the effect on my current health.
I acknowledge my responsibility to ensure adequate medical personal health, dental and accident insurance coverage, as well as protection of my personal possessions.
I have read and understood this agreement and I am aware that by signing this agreement I am waiving certain legal rights which I or my heirs, next of kin, executors or administrators may have against the Releasees.
WAIVER SIGNED BY (type name):