ONLINE WAIVER: Watersports SummerCamp 2017

In order to participate in Miamikiteboarding's SummerCamp, please fill in the Waiver form below. ALL FIELDS ARE REQUIRED.

Registration Form
Please fill out ONE FORM PER CHILD. Incomplete forms will not be accepted. All fields are required.
First Name: *
Please Write complete name of Child
Your answer
Last Name: *
Your answer
Gender: *
Date of Birth: *
MM / DD / YYYY (required)
Your answer
Email Address of PARENT. *
This email address will be used for all communications, including lates photos from the camp.
Your answer
USA Mobile Phone #: *
Phone # (required)
Your answer
Out of USA Phone #:
(only if applies)
Your answer
EMERGENCY Phone #: *
Include a Contact Person
Your answer
Street Address: *
Your answer
City: *
City
Your answer
State , ZIP , Country *
Your answer
What Week or Session are you registering for ? *
Your answer
List Name & Phone # of other designated adult allowed to pick up your children *
Your answer
Do you authorize MiamiKiteboarding inc to use the pictures featuring your children for our marketing purposes ? *
WAIVER FORM --- KAYAKING, BOARD SURFING, KITESURFING, KITEBOARDING, BOATING, RELEASE OF LIABILITY WAIVER OF LEGAL RIGHRS AND ASSUMPTION OF RISK.
In consideration for the renting, purchasing, or leasing of Kiteboarding equipment from MKB and/or the utilizing of the facilities, ground school, instruction, premises, and equipment of MKB in engaging in the sport of Kayaking, Board Surfing, Kitesurfing, Kiteboarding, Windsurfing, Boating and Snow Kiting ground instruction, water instruction, and related activities (hereinafter collectively called “Kiteboarding Activities”), I hereby understand and agree to this release of liability, waiver of legal rights, and assumption of risk, and to the terms hereof as follows:
1. I acknowledge that Kiteboarding is an action sport and recreational activity involving travel in three dimensions and such activity is subject to mishap and even injury to participants. I understand I may suffer a broken limb, paralysis, or fatal injury while participating in the sport of Kiteboarding. *
Check the box in signal of agreement:
Required
2. I hereby RELEASE AND DISCHARGE Miamikiteboarding Inc and its officers, employes and related staff, its president Christophe Ribot, Miami Dade County, their officers, directors, elected officials, agents, employees, instructors, lessors, and owners of equipment and the land used for Kiteboarding Activities (hereinafter referred to as “Released Parties”), from any and all liability, claims, demands, or causes of action that I may hereafter have for injuries, disability, or death, or damages arising out of my participation in Kiteboarding Activities, including, but not limited to, losses CAUSED BY THE NEGLIGENCE OF THE RELEASED PARTIES. *
Check the box in signal of agreement:
Required
3. I understand and acknowledge that Kiteboarding Activities have inherent dangers that no amount of care, caution, instruction, or expertise can totally eliminate. I EXPRESSLY AND VOLUNTARILY ASSUME ALL RISK OF DEATH OR PERSONAL INJURY SUSTAINED WHILE PARTICIPATING IN KITEBOARDING ACTIVITES WHETHER OR NOT CAUSED BY THE NEGLIGENCE OF THE RELEASED PARTIES. *
Check the box in signal of agreement:
Required
4. I further agree that I WILL NOT SUE OR MAKE A CLAIM against the Released Parties for damages or other losses sustained as a result of my participation in Kiteboarding Activities. *
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Required
5. I also agree to INDEMNIFY AND HOLD THE RELEASED PARTIES HARMLESS from all claims, judgments, and costs, including attorney’s fees, incurred in connection with any action brought as a result of my participation in Kiteboarding activities. *
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Required
6. I will take full responsibility for, and hold harmless, Released Parties for any injury that I may suffer or inflict upon others or their property as a result of my engaging in Kiteboarding activities. *
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Required
7. I have read and understand the above and acknowledge that the same constitutes a release of liability and a waiver of my legal rights and also acknowledgement of the assumption by me of all risks arising out of my engaging in Kiteboarding activities. *
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Required
8. I further represent that this release of liability, waiver of legal rights, and assumption of risk shall continue in full force and effect for so long as I engage in Kiteboarding activities which are in any way connected to or with the released parties. *
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Required
9. I further represent that I am at least 18 years of age or that as the parent or legal guardian I waive and release any and all legal rights that may accrue to me or to my minor child as the result of any injury that my son or daughter (minor) may suffer while engaging in Kiteboarding activities. *
Check the box in signal of agreement:
Required
10. I hereby expressly recognize this Release of Liability, Waiver of Legal Rights, and Assumption of Risk is a contract pursuant to which I have released any and all claims against the Released Parties resulting from my participation in Kiteboarding activities including any claims of the Released Parties by any of the undersigned. *
Check the box in signal of agreement:
Required
I have read the above declarations, understand them, and I agree to be bound by them.
I HAVE READ THIS RELEASE OF LIABILITY, WAIVER OF LEGAL RIGHTS, AND ASSUMPTION OF RISK, AND FULLY UNDERSTAND ITS CONTENTS AND SIGN IT OF MY OWN FREE WILL AND AGREE TO BE BOUND BY IT.

DIGITAL SIGNATURE OF ADULT PARTICIPANT --- By Signing your Full Name you agree to the terms and are bound by it. *
I have read the above declarations, understand them, and I agree to be bound by them. (ADULT MUST SIGN THE FORM BY WRITING NAME)
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