Registration
Form for Silver Run Ski Education Foundation
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Name___________________________
USSA Number______________________
Will you
need lodging? Yes_____ No ______
Medical Release We (I)____________________________, the parent (s) or guardian (s) of _________________________________, a minor, entrust such minor into the care of Silver Run Ski Education Foundation adult coach(es) or adult chaperon(s) for those periods of time this ski season when the above-named minor is attending practice sessions or races as a member of Silver Run Ski Education Foundation. In such connection we authorize such caring adult(s) to obtain medical aid for our son/daughter in case of injury or illness. It is understood that every effort will be made to contact us if medical attention becomes necessary. Signature
of Parent (s)/ Guardians__________________________
Date_______ ______ ATHLETE INFORMATION Allergies
__________________________________________________________
INSURANCE COVERAGE (REQUIRED) Company
Name________________________________ Policy Number________
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Red Lodge International Ski and Snowboard Camp Name________________________
Age_____ Date____________
Waiver and Release of Liability I voluntarily request to participate or to have my minor child participate in ski and/or snowboard activities. I should not enter and participate unless I am medically able and properly trained. I agree to visually and physically inspect the area and the adjacent area before using the area. I know that participating in any snowboarding and skiing event is a dangerous activity. I accept such risk on behalf of myself and/or my minor child. KNOWING THESE FACTS, and in consideration of the Red Lodge International Summer Race Camp accepting my entry, on behalf of myself and/or my minor child named on this registration, I EXPRESSLY ACKNOWLEDGE AND AGREE that participating in this event is dangerous and involves the risk of serious injury and/or death. I, HEARBY, RELEASE, HOLD HARMLESS and INDEMNIFY Red Lodge International Summer Camp, Inc., its shareholders, officers, directors, and employees, the Department of Agriculture, U.S. Forest Service, as well as any event sponsors, from any and all claims of liability for damage or personal injury of any kind or nature whatsoever arising out of or in the course of my participation in this event. I FURTHER EXPRESSLY AGREE that the foregoing release, waiver, and indemnity agreement is intended to be broad and inclusive as is permitted by the laws of the State of Montana and Wyoming and that if any portion thereof is held invalid, it is agreed that the balance shall notwithstanding, continue in full legal force and effect. I UNDERSTAND THAT this is a release of liability which will legally prevent me or any other person from filing suit or making any other legal claims against Red Lodge International Summer Race Camp, Inc., its shareholders, officers, directors, and employees. I or my parent/guardian, nevertheless, enter into this agreement freely and voluntarily and agree that it is binding upon me, my heirs, assigns and legal representatives. The undersigned further grants full permission to use any photographs, videotapes, motion pictures, recordings or any other record of these events for any purpose. PARTICIPANTS PERFORMING INVERTED AERIAL MANEUVERS ARE OUTLAWED. I have carefully read this Waiver and Release of Liability, understand it, and accept its terms. Participants' Signature:_____________________________Date:_____________ Parent/Guardian Signature:_________________________Date:______________ |