2019 Texas Sailing Association Participation
The information and consent provided below will be shared with the regatta hosts at each TSA venue.
Email address *
First Name of Participant *
Your answer
Last Name of Participant *
Your answer
Participant Date of Birth *
MM
/
DD
/
YYYY
Participant Home Address *
Your answer
Participant Club or Team *
Indicating your club or team here allows regatta hosts and safety volunteers to locate a sailor's coach or group at an event.
Required
Name of Parent or Guardian 1 *
Your answer
Phone of Parent or Guardian 1 *
Your answer
Name of Parent or Guardian 2
Your answer
Phone of Parent or Guardian 2
Your answer
Name of Alternate Emergency Contact at Events
Your answer
Phone of Alternate Emergency Contact at Events
Your answer
MEDICAL CONSENT FORM
In the event of accident, injury or illness involving any child of mine (specifically including my child named above as the "Participant") or me or my spouse while in, on, or about the premises of a Texas Sailing Association (“TSA”) member yacht club (the "Club") (which includes all venues listed here: txsail.org/youth-sailing/tsa-youth-circuit-2019/ ) or while participating in any activity sponsored by or under the auspices of said Club under circumstances where I am physically unable to consent or am not present,
1. I hereby voluntarily authorize and consent to the furnishing to myself, my spouse, or any child of mine of such medical care, attention, and treatment by any hospital, physician or dentist as such hospital, physician or dentist may deem necessary or advisable, including any x-ray examination, anesthetic, medical, or surgical diagnosis or procedure.
2. I authorize any adult associated with the activity to consent to such medical care, attention and treatment.
3. I agree to pay the reasonable cost of such medical care, attention or treatment and to indemnify and hold free and harmless of and from any and all liability for such cost the assisting adult, the Club, TSA and the officers, employees and members of said organizations.
It is understood that effort shall be made to contact the undersigned prior to rendering treatment to the patient, but that any of the above treatment will not be withheld if the undersigned cannot be reached.
Medical Consent Form *
Name of Adult Signing Consent *
Your answer
LIABILITY RELEASE AGREEMENT
IN CONSIDERATION OF ACCEPTANCE OF MY CHILD’S REGISTRATION TO PARTICIPATE IN THE REGATTA AND, RECOGNIZING THE RISKS ASSOCIATED WITH THE SPORT OF SAILING, THE UNDERSIGNED HEREBY WAIVES ALL CLAIMS FOR PERSONAL INJURY AND PROPERTY DAMAGE AND HEREBY RELEASES THE TEXAS SAILING ASSOCIATION, THE HOST CLUBS AND ALL OF THEIR DIRECTORS, OFFICERS, MEMBERS, EMPLOYEES, AND THE REGATTA VOLUNTEERS AND SPONSORS, OF AND FROM ANY AND ALL CLAIMS AND LIABILITIES OF WHATEVER KIND, INCLUDING THOSE OF NEGLIGENCE AND GROSS NEGLIGENCE, WHICH I OR MY CHILD MIGHT HAVE, ARISING OUT OF MY CHILD’S PARTICIPATION IN THE REGATTA AND ALL ACTIVITIES RELATING THERETO.
Liability Release Agreement *
Name of Adult Signing Liability Release *
Your answer
Release Emergency Information to Host Clubs *
I agree that the above information can be shared with TSA host clubs.
A copy of your responses will be emailed to the address you provided.
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