Participant Waiver Form

CLCR Participant Member Waiver

  • THIS IS YOUR RELEASE AND WAIVER OF LIABILITY
    (the “Release”). You individually and on behalf of any minor child, release the Coventry Lake Community Rowing Inc. (CLCR), its officers, directors, board members, employees, volunteers, agents, independent contractors, other participants and/or others acting on its behalf (collectively, “CLCR”). You agree that this Release is effective immediately. This is important to you and any minor children, so do not sign until you have had your questions answered. You provide this Release freely, and without duress under the following terms:
    1) GENERAL RELEASE, INDEMNIFICATION AND HOLD HARMLESS
    : I hereby agree for myself and my child and our respective heirs, assigns and legal representatives, to indemnify, defend and hold CLCR and its officers, directors, board members, employees, volunteers, agents, independent contractors and other participants (“Releases”) harmless from any and all claim and causes of action of any nature for any and all personal injury or illness, including death, which may occur to my child or which may be aggravated during or by any activity during the course of the program in which I have decide to allow [myself or my child] to engage. I further waive any and all claims or causes of action which I or my child may now or hereafter have against CLCR which may at any time arise as a result of any act or thing occurring in or arising out of [my or my child’s] participation. I further expressly understand and agree the foregoing indemnity, release and waiver is intended to be as broad and inclusive as permitted by the laws of the State of Connecticut and that any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full force and effect.
    2) ASSUMPTION OF RISK: I, individually and/or on behalf of any minor child(ren), expressly and specifically assume any and all risk of injury, illness, death, or property damage resulting from CLCR. You assume the risks: I, individually and on behalf of my minor child(ren),understand that CLCR activities are strenuous and dangerous. I understand that the activity should be engaged in only by persons in good health. I understand that I should consult a physician before enrolling myself or my child(ren). Once you sign, you are saying that you understand the risks involved and accept all of the risks. You acknowledge that CLCR is a charitable organization and that you are a beneficiary of CLCR.
    3) MEDICAL RELEASE: I, individually or on behalf of any minor child(ren), hereby release CLCR from any claim whatsoever which may arise as a result of any first aid, treatment, or services or assistance provided to me or my minor child(ren) in connection with any injury that arises.

    A) I take full responsibility for my welfare and safety as well as my child(ren).
    B) I hereby give permission for emergency medical treatment to be administered as deemed appropriate.

    4) INSURANCE: YOU ARE EXPECTED TO HAVE YOUR OWN HEALTH INSURANCE. You should understand that CLCR does not carry insurance to cover injuries and losses that may befall you.
    5) YOUR RELEASE IS COMPLETE. It discharges CLCR from any liability or claim that you may have with respect to any bodily injury, personal injury or property damage that may result. Your release is complete whether your claim is due to negligence of CLCR or is based on any other legal or other theory whatsoever. In addition, you acknowledge that CLCR is a charitable organization and that you are a beneficiary of CLCR.
    6) SCOPE OF THIS RELEASE. This Release is intended to be as broad and inclusive as permitted by the laws of the State of Connecticut. This Release shall be governed by and interpreted in accordance with the laws of the State of Connecticut. You agree that in the event that any court of competent jurisdiction shall hold any clause or provision of this Release invalid, the invalidity of such clause or provision shall not otherwise affect the remaining clauses or provisions of this Release, which shall continue to be enforceable.
    7) PHOTOGRAPHIC/VIDEO RELEASE. I grant CLCR the right and license to photograph/video me singly or with others. I understand that my or my child(ren’s) image may be recognizable and that CLCR may use this image as it sees fit. I release CLCR from any obligations to me or my heirs or assigns for such photographs, specifically releasing CLCR from any obligation to pay a fee or royalties for any use of your photographic image.
    8) SIGNATURES. “Applicant” refers to the individual who is the participant. If there are multiple Applicants from the same family participating in, each must sign individually. If “Applicant” is under the age of 18, either parents or legal guardians must sign “Individually and as Parent and/Legal Guardian”. HAVING READ, UNDERSTOOD, AND AGREED WITH THESE TERMS, I HAVE EXECUTED THIS RELEASE, TO BE EFFECTIVE IMMEDIATELY.

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