The
2nd Annual Friends
of Pleasant Bay
Regatta
Registration
Form
Type
of Boat Being Registered
Number
Name
of Skipper
Address
(incl. town/zip)
Phone
Number
Email Address
Name
of Crew
Address
(incl. town/zip)
Phone
Number
Email Address
Name
of Crew
Address
(incl. town/zip)
Phone
Number
Email Address
Name
of Crew
Address
(incl. town/zip)
Phone
Number
Email Address
Liability Release, Parental
Consent and Permission to Treat Form
I/We,
the undersigned skipper/participant and/or parent(s) or guardian(s) of the
minor skipper/participant listed on this form, do hereby consent to participation in the
Friends of Pleasant Bay Regatta sponsored by Pleasant Bay Community
Boating. I/We, do hereby, for
ourselves, our heirs, spouses, family members, personal representatives and
assigns, agree to indemnify and hold
harmless Pleasant Bay Community Boating, its officers, board members,
employees, members, volunteers, and any
individuals and organizations assisting or participating in its programs,
against any and all suits, actions,
claims, costs or demands, whether arising from sole or concurrent negligence
or otherwise including those, resulting
from death, personal injury, and property damage, to which Pleasant Bay Community Boating, its officers, board
members, employees, members, volunteers, and any individuals and organizations assisting or participating in
its programs may be subject by reason of the students listed on this form participating in the Friends of Pleasant
Bay Regatta and/or their presence on board any of its boats, floats, facilities, or any other
places in connection with Pleasant Bay Community Boating.
I/We
understand that sailing, kayaking, canoeing, rowing, etc. are hazardous sports.
I/We also understand that to minimize the hazard as much as possible, the
participant(s), if permitted to participate in the instructional program, will
be subject to the rules of Pleasant Bay Community Boating and the control of
the instructional staff – both employees and volunteers.
I/We
hereby authorize any of the members, officers, board members, employees, or
volunteers of Pleasant Bay
Community Boating to give permission to any physician, hospital,
or other medical practitioner or facility for
any medical, surgical, dental, or other treatment that may be necessary
or desirable for the participants’ well being
in the event of illness or bodily injury. If major emergency, surgical treatment is
immediately required, I/we request that
reasonable efforts be made to reach me for consultation, but understand that
such consultation is not a prerequisite
for such treatment.
I/We
agree as skipper of a boat with more than one participant, that we are
responsible for the decision to participate, for the handling of the boat, and
for the conduct of all persons in the boat, who are acknowledged to indemnify
and hold harmless Pleasant Bay Community Boating in the same manner as
described above.
I/We
understand that the Friends of Pleasant Bay are in no way responsible for the
organization and conduct of this regatta.
I/We
have read and do understand the terms of this agreement.
Name: Signed:
Date:
Skipper/participant and/or Parent(s) or Guardian(s) of minor
skipper/participant