Potomac Boat Club Waiver and Release of Liability Agreement 2019
Dear Members, Guests, and Competitive Program Participants:
All Potomac Boat Club members, guests, and competitive program participants are required to sign a liability waiver on an annual basis acknowledging personal responsibility to use PBC’s facilities and equipment. Please read the following POTOMAC BOAT CLUB WAIVER AND RELEASE OF LIABILITY AGREEMENT for 2019. If you agree to the waiver, provide the information requested, then press "SUBMIT."
If you prefer to complete a hard copy version of the form, the Club makes them available at the Logbook station. Simply fill one out before participating in any Club Activity and deposit it in the MEMBERSHIP COMMITTEE MAIL SLOT under the logbook.
If you have any questions regarding this form, please contact Carol Dinion, PBC Membership Chair, at
WAIVER AND RELEASE OF LIABILITY AGREEMENT
I, the individual named below, IN CONSIDERATION of being given the opportunity by POTOMAC BOAT CLUB to participate at POTOMAC BOAT CLUB in activities, competitions, practices, training and any other form of participation in water sports, including but not limited to rowing, kayaking, and canoeing, whether recreational or competitive in nature, whether on the water or on land, and whether or not in the presence of or accompanied by a coach or others, and also including but not limited to any other activities in furtherance of the Club or its mission and upkeep (collectively referred to as "Club Activities" or "Rowing Activities" herein) for myself, my personal representatives, assigns, heirs, and next of kin, do hereby declare the following:
I ACKNOWLEDGE, agree and represent that I understand the nature of Club Activities, and that I am qualified, in good health, and in proper physical condition to participate in all Club Activities;
I FULLY UNDERSTAND that (a) CLUB ACTIVITIES MAY INVOLVE RISK AND DANGER of serious bodily injury, including permanent disability, paralysis and death ("Risks"); (b) these Risks and Dangers may be caused by my own actions, or inactions, the actions or inactions of others participating in Club Activities, the condition in which Club Activities takes place, or the negligence of the Releasees named or referred to below; (c) there may be other risks and social and economic losses either not known to me or not readily foreseeable at this time, and
I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I may incur as a result of my participation in Club Activities.
I AGREE AND WARRANT that I will examine and inspect each Club Activity in which I take part, and if I observe any condition that I consider to be unacceptably hazardous or dangerous, I will notify the proper authority in charge of the Club Activity and will refuse to take part in the Club Activity until the condition has been corrected to my satisfaction.
I HEREBY RELEASE, discharge and covenant not to sue Potomac Boat Club, its administrators, governors, coaches, captains, agents, officers, volunteers and employees, and in the event of my participating in any regatta attended or organized by Potomac Boat Club, the regatta organizers, any sponsors, advertisers, and if applicable, owners and lessors of premises on which the regatta takes place (each considered one of the Releasees herein) from all liability, claims, demands, losses or damages on my account caused or alleged to be caused in whole or in part by the negligence of the Releasees or otherwise, including any claims arising from travel to or from regattas or other Rowing Activities and claims arising from negligent rescue operations; and I further agree that if, despite this release and waiver of liability, assumption of risk, and indemnity agreement, I, or anyone on my behalf, makes a claim against any of the Releasees, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS each of the Releasees from any litigation expenses, attorney fees, loss, liability, damage, or cost which any may incur as a result of such claim.
I have read the agreement above, fully understand its terms, understand that I have given up substantial rights by signing it (which I do electronically by submitting this form) and I have entered into this agreement freely and without any inducement or assurance of any nature and intend it be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid, the balance, notwithstanding, shall continue in full force and effect.
Phone number (ex. 2021234567, no dashes, numbers only)
Country (if other than USA)
PARENTAL CONSENT FOR A MINOR
If this section does not pertain to you, please skip to the SUBMIT button at the end of this form.
AND I, parent and/or legal guardian of the MINOR named below, understand the nature of Rowing Activities and the minor's experience and mental and physical capabilities, and believe the minor to be qualified and able to participate in Rowing Activities. I hereby release, discharge, covenant not to sue, and AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS each of the Releasees described above from all liability, claims, demands, losses, or damages on the minor's account caused or alleged to be caused in whole or part by activities described above, and further agree that if, despite this release, I, the minor, or anyone on the minor's behalf makes a claim against any of the above Releasees, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS each of the Releasees from any litigation expenses, attorney fees, loss, liability, damage, or cost that may be incurred as the result of any such claim.
Parental consent agreement
YES, I agree
NO, I do not agree
Name of Minor
Name of Parent and/or Legal Guardian of Minor named above
By pressing SUBMIT below and submitting this form, I declare that I am the adult named in the AGREEMENT / IDENTIFICATION section above, that all of the information provided is true, and that I voluntarily enter into this agreement, effective on the date of submission.
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