Winter Break SAQ Clinic - Registration Form
River City Sports Performance's WINTER BREAK SAQ CLINIC series registration form.  Please fill out completely.
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First Name *
Athlete's first name
Last Name *
Athlete's last name
Age *
Athlete's current age
Gender *
Email Address *
best address to contact regarding registration and participation
Phone Number *
best number to contact regarding registration and participation
Please choose your session *
Choose from the following option
Emergency Contact Information
Emergency Contact Name *
Emergency Contact phone number *
WAIVERS and RELEASES
Waiver of Liability *
Waiver: In consideration of permission to use, today and on all future dates the property, facilities, and services of River City Sports Development LLC I, on behalf of myself, my heirs, personal representatives, or assigns, do hereby release, waive, discharge, and covenant not to sue, River City Sports Development LLC, its directors, officers, employees, volunteers, independent contractors, and agents from liability from any and all claims arising from the ordinary negligence of River City Sports Development LLC or any of the aforementioned parties. This agreement applies to 1) personal injury (including death) from accidents or illnesses arising from the participation in River City Sports Development LLC activities including, but not limited to, organized activities, classes, observation, and individual use of facilities, premises, or equipment; and to 2) any and all claims resulting from the damage to, loss of, or theft of property.  Indemnification and Hold Harmless: I agree to HOLD HARMLESS AND INDEMNIFY River City Sports Development LLC from all claims resulting from negligence and to reimburse them for any expenses incurred by River City Sports Development LLC in investigating and defending a claim or suit if my claim is withdrawn, or to the extent a court or arbitration determines that River City Sports Development LLC is not responsible for the injury or loss.   Severability and Venue: The undersigned further expressly agrees that the foregoing waiver and assumption of risks agreement is intended to be as broad and inclusive as is permitted by the law of Oregon and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect  Acknowledgement of Understanding: I have read this waiver of liability and indemnification agreement and fully understand its terms. I understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am signing the agreement freely and voluntarily, and intend my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law in the State of Oregon.  Assumption of Risks: Physically activity, by its very nature, carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries.  River City Sports Development LLC has facilities for and provides for activities such as weight lifting, sports-specific skills training, walking, jogging and running, aerobic activities, speed development, agility, and plyometrics. Some of these involve strenuous exertions of strength using various muscle groups, some involve quick movements involving speed and change of direction, and others involve sustained physical activity, which places stress on the cardiovascular system.  The specific risks vary from one activity to another, but in each activity the risks range from 1) minor injuries such as scratches, bruises, and sprains to 2) major injuries such as loss of sight, joint or back injuries, concussions, and heart attacks to 3) catastrophic injuries including paralysis and death.  I have read the previous paragraphs and I know the nature of the activities at River City Sports Development LLC, I understand the demands of those activities relative to my physical condition and skill level, and I appreciate the types of injuries, which may occur as a result of activities made possible at River City Sports Development LLC. I hereby assert that my participation is voluntary and that I knowingly assume all such risks.  Acknowledgement of Understanding: I have read this assumption of risk and full understand its terms. I acknowledge that I am signing freely and voluntarily and intend my signature to signify a complete assumption of the inherent risks of participating or observing recreational activities at River City Sports Development LLC to the greatest extent allowed by law in the State of Oregon.
Photo/Video Release *
I, the undersigned, do hereby consent and agree that RIVER CITY SPORTS DEVELOPMENT LLC, its employees, or agents have the right to take photographs, videotape, or digital recordings of me to use these in any and all media, now or hereafter known. I further consent that my name and identity may be revealed therein or by descriptive text or commentary. I do hereby release to RIVER CITY SPORTS DEVELOPMENT LLC, its agents, and employees all rights to exhibit this work in print and electronic form publicly or privately and to market and sell copies. I waive any rights, claims, or interest I may have to control the use of my identity or likeness in whatever media used. I understand that there will be no financial or other remuneration for recording me, either for initial or subsequent transmission or playback. I also understand that RIVER CITY SPORTS DEVELOPMENT is not responsible for any expense or liability incurred as a result of my participation in this recording, including medical expenses due to any sickness or injury incurred as a result. I represent that I have read and understand the foregoing statement, and am competent to execute this agreement.
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