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The Gateway Disabled Ski Program
Insurance Waiver and Release of Liability
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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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Media Release
I hereby authorize and give my full consent to The Gateway Disabled Ski Program to copyright and/or publish all photographs, video tapes and/or film in which I appear while attending The Gateway Disabled Ski Program events. I further agree that The Gateway Disabled Ski Program may transfer, use or cause to be used, these photographs, videos or films for any exhibitions, public displays, publications, commercials, art and advertising purposes, and television programs without limitations or reservations.
Signature________________________ Date__________________
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