名字
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第一个名字
姓
电子邮件
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电话
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Can we communicate with you via your mobile phone?
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Over the age of 18?*
You must have prior approval to bring a minor with you to BC菠菜导航家. Do you need us to call you to discuss bringing a minor?
Address
地址1
地址2
城市
州/省
邮政编码
国家
How did you hear about LYDIA?
Comments (Please include any additional information you'd like for us to know here)
责任豁免
ACCIDENT WAIVER AND 释放 OF LIABILITY FORM
I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES ASSOCIATED WITH BC菠菜导航家 ASSOCIATION, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, 维护, or controlled by them, or because of their possible liability without fault.
I certify that I am physically fit, have sufficiently prepared or trained for participation in this activity, and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in this activity.
I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holders, 赞助商, and 组织者 of the activity in which I may participate, and that it will govern my actions and responsibilities at said activity.
In consideration of my application and permitting me to participate in this activity, I hereby take action for myself, 我的执行人, 管理员, 继承人, 近亲, 继任者, and assigns as follows:
(a)我放弃, 释放, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, 为了我的死亡, 残疾, 人身伤害, 财产损失, 产权, or actions of any kind which may hereafter occur to me including my traveling to and from this activity, THE FOLLOWING ENTITIES OR PERSONS: LYDIA Home Association and/or their directors, 军官, 员工, 志愿者, 代表, 和代理, and the activity holders, 赞助商, 和志愿者;
(B)赔偿, 持有无害的, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of releasee or otherwise.
I acknowledge that LYDIA and their directors, 军官, 志愿者, 代表, 和代理 are NOT responsible for the errors, 遗漏, 徒, or failures to act of any party or entity conducting a specific activity on their behalf.
I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, 事故, and/or illness during this activity.
I understand while participating in this activity, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the activity holders, 生产商, 赞助商, 组织者, 和转让人.
The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.
协议*
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BY CHECKING THE AGREE BOX ONLINE, I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A 释放 OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL.
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