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In consideration of being allowed to participate in
any way in the The Gateway Disabled Ski Program, related events and activities, I and/or the minor participant and next of
kin, the undersigned:
1. Agree that prior to participation in The Gateway Disabled Ski Program will inspect, or if
a parent or legal guardian will instruct the minor participant to inspect the facilities and equipment to be used, and if
I believe to the best of my ability that anything is unsafe, I and/or the minor participant will immediately advise the Gateway
Disabiled Ski Program of such condition(s)and refuse to participate.
2. Acknowledge and fully understand that I and/or
the minor participant, will be engaging in activities that involve risk of serious injury, including permanent disability
and death, and severe social and economic losses which might result only from my own actions, inactions or negligence of others,
the rules of play, or the condition of the premises or any equipment used. Further, that there may be other risks and accept
personal responsibility for the damages following such injury, permanent disability or death.
3. Release, waive,
discharge and covenant not to sue The Gateway Disabled Ski Program, their representative administrators, directors, agents,
coaches, volunteers and others affiliated with the organization, including other participants, sponsoring agencies, sponsors,
advertisers, heirs and if applicable, owners and leasers of premises used to conduct the event, all of which are hereinafter
referred to as "releasees", from demands, losses or damages on account of injury, including death or damage to property, caused
or alleged to be caused in whole or in part by the negligence of the Releasee or otherwise.
I, (athlete, parent or
legal guardian) have read the above waiver and release, understand that I have given up substantial rights by signing it,
have not changed it orally, and sign it voluntarily.
Participant's Name (print)________________________________
Signature
________________________________________________
Date______________________________________________________
FOR
MINORITY AGE PARTICIPANTS:
This is to certify that I, as parent/legal guardian with legal responsibility for this particpant,
do consent and agree to his/her release as provided above of the Releasees, and for myself, my heirs, assigns, and next of
kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child's
involvement or participation in The Gateway Disabled Ski Program as provided above, EVEN IF ARISING FROM PARTICIPANT'S NEGLIGENCE.
Parent/Guardian's Name __________________________
Signature_________________________________________________
Date______________________________________________________
Emergency
Contact
Name___________________________________ Phone ____________
Name___________________________________ Phone ____________
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