Waiver and Release of Liability Form
Waiver and Release of Liability Form
Waiver, Release of Liability & Consent for Medical Treatment

NOTE: WAIVERS MUST BE COMPLETED & SIGNED IN ORDER TO BE ELIGIBLE TO COMPETE IN THE NH COACHES SERIES RACES. COACHES ARE NOT ALLOWED TO REGISTER THEIR SKIERS UNTIL THE WAIVERS HAVE BEEN SUBMITTED.

In consideration of myself or my child participating in nordic ski related activities, and/or other activities offered by the New Hampshire Nordic Coaches Association (herein after referred to as “NHNCA”), I acknowledge and agree to be bound to the following:

1. Identification of Risks: I understand that participation in any skiing activity, including but not limited to preparation for and participation in, nordic ski competitions and practices, involves risk of serious injury, including permanent disability, death and other losses, due to inactions or negligence of myself or others.

2. Assumption of the Risk: I agree that I am responsible for my safety while participating in activities associated with NHNCA, and that such responsibility includes participation only a) when I am both physically and psychologically prepared to participate safely, b) after fully familiarizing myself with the venue before beginning the activity, and c) while using the equipment of a type and condition reasonably necessary to safely participate. I assume all risk connected with responsibility for any injury or loss connected with my participation.

3. Waiver: Aware of the risks and willing to assume them, I hereby release and agree to hold harmless the NHNCA, its officers, directors, employees, agents, coaches, trainers, doctors, officials, volunteers, affiliates, event organizers, sponsors, owners of property and trails used by me (Released Parties) from loss, injury, or death to myself or other person, or other damage to person or property resulting from my participation in events and competition and any related activities including, without limitation activities in connection with sponsorship, organization or execution of any special event and travel to and from such event, whether I may participate as an athlete, coach, volunteer, spectator, or in any other manner associated with NHNCA. This release is intended as a waiver of any claim I may have whether based upon negligence, breach of warranty, contract, or other legal theory, against any of the above Released Parties, accepting myself the full responsibility for any such loss, injury, death or damage that may result. I intend for this release to also apply to my relatives, personal representatives, heirs, beneficiaries, next of kin and assigns. This waiver does not release acts of gross negligence or willful and wonton misconduct of any party.

4. Consent for Medical Treatment: I agree and give consent to the NHNCA, its officers, directors, employees, agents, coaches, trainers, officials, volunteers, organizers, and sponsors to seek and obtain on my behalf emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well-being of my dependent.

5. Image: I grant NHNCA to use my name, and any photograph, video, image, results or record of me from any NHNCA event for all purposes NHNCA may choose.

I have read this Waiver, Release of Liability and Consent for Medical Treatment agreement, and understand that I have given up substantial rights by signing it, and have signed it freely and without any inducement or assurance of any nature, and intend it to be a complete and unconditional release of all liability and consent of medical treatment to the greatest extent allowed by law. If any part of this agreement is determined to be unenforceable, all other parts shall continue in full force and effect.

Skier First Name *
Your answer
Skier Last Name *
Your answer
Skier 4-Digit Birth Year *
2004 & 2005 Birth Years are eligible for the 2020 NENSA U16 Championships. NOTE: 5TH GRADERS ARE NOT ELIGIBLE TO COMPETE IN THE NH COACHES SERIES RACES.
Email Address *
Your answer
Team Name (School or Club) *
Acceptance of Terms and Conditions *
Check here if you agree to the conditions of this waiver, release of liability, and consent for medical treatment.
Required
Electronic Signature of Skier *
(Type Full Name)
Your answer
Parent/Guardian Signature for Minors (under 18 yrs old)
(Type full name)
Your answer
Comments (If you selected 'OTHER' as your Team Name, please specify here)
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.