Agreement for Voluntary Participation In
Trach Power Skating & Curtis Kulchar Conditioning
There is a risk of injuries, serious and minor, associated with participation in any sport, and training for a sport. The risks may increase in activities involving physical contact, running, jumping, or otherwise leaving one`s feet, diving, sliding, or interaction with moving objects that are thrown, or otherwise used in the sport. The risks include, but are not limited to: injury to the head, neck or spine (including paralysis); injury to the muscular to skeletal systems; injury to internal or external organs; loss or damage to sight, hearing, or teeth; death; long or short-term disability; loss of income, career opportunities, or the enjoyment of life; pain; and scarring or disfigurement.
IT IS THE RESPONSIBILTIY OF EACH INDIVIDUAL PARENT to know his or her owns child`s state of health and well-being, and therefore to be able to certify that he or she is physically fit to participate in the on-ice and off-ice portions of the hockey camp.
Therefore, AS A PRECONDITION TO BEING GRANTED PERMISSION TO PARTICIPATE IN THIS CAMP, EACH PARTICIPANT`S PARENT shall read the agreement set forth below in order to make an educated choice to participate or not participate. Your initials will signify your recognition of the possible health risks involved and your informed consent to them.
To that end, and before releasing Trach Power Skating and Curtis Kulchar from all actions, claims, or demands related to any injury your child may sustain as a result of participating in this hockey camp both on and off the ice and in the complex and vicinity the camp is being held, please give serious consideration to the possible ramifications. You should understand that the causes of possible injury are many, but among them are: injury from bodily contact, incidental or inherent in the nature of the sport; slipping, falling, or tripping on the playing surface, regardless of its physical or environmental conditions; injury from warming up, practicing, or training for game participation; or to rules, regulations, particularly in contact sports; or injury due to a disparity between and among other players or teams with respect to experience level, strength, height, weight, age, ability, and the relative competitiveness or maturity of, between, or among other participants.
FAILURE TO COMPLETE THIS FORM IN ITS ENTIRETY WILL RESULT IN THE EXCLUSION OF THE INDIVIDUAL FROM THIS HOCKEY CAMP
I ______________________ (Guardian) have read the above AGREEMENT FOR VOLUNTARY PARTICIPATION IN TRACH POWER SKATING AND CURTIS KULCHAR CONDITIONING and understand its content. I acknowledge the risk of injury from participation and am willing to and hereby do voluntarily assume all risks of harm associated with participation.
I certify to the best of my knowledge, my child is physically fit and able to participate in this hockey camp both on and off ice, that he/she is in good health, and that I am unaware of any medical condition, which might make participation inadvisable. X_______________________ (initials of parents)
I am aware that participating in Trach Power Skating or training with Curtis Kulchar may expose my child to a risk of injury, minor or serious, including those listed above in the AGREEMENT FOR VOLUNTARY PARTICIPATION IN TRACH POWER SKATING AND CURTIS KULCHAR CONDITIONING. I accept and assume all risks, Known and unknown, listed or unlisted, that may result from my child`s voluntary participation in activities related to such sports, regardless of the cause of injury.
X__________________________ (initials of parent)
In consideration of Trach Power Skating and Curtis Kulchar permitting my child to participate in its camps, I knowingly and intentionally give up any legal right that I, my heirs, or legal representatives have or may have against, its trustees, persons, officers, agents, employees, from any action, claim, or demand that I, my heirs, or my legal representatives have or may have for any and all personal injuries my child may suffer or sustain, regardless of cause of fault, on-or-off the field, as a result of my child`s voluntary participation in Trach Power Skating or training with Curtis Kulchar and/or in other related thereto. X_______________________(initials of parent)
I knowingly intend that my initials on this Agreement to be a complete defense to any legal proceeding that may be brought by anyone on their own of on my behalf for any injury my child my suffer or sustain as a result of voluntarily participating in Trach Power Skating or training with Curtis Kulchar or in activities related thereto, and further intend this Agreement to be a complete and total release to liability for all negligent acts, failures to act, or breaches of duty owned to my child, which result in my child’s personal injury or death as a result of my child`s voluntary participation in Trach Power Skating or training with Curtis Kulchar. X______________________ (initials of parents)
I certify that I am 18 years of age or older, that I am legally competent and capable of executing this agreement on behalf of my child and that I have read the foregoing and have made, a conscious decision to sign it of my own free will.
Child`s Name _________________________________
Signature of Gaurdian _________________________________________