Selkirk Saints Golf Camp Registration
Selkirk Saints Golf Camp Registration
July 10-13, 2023
Participant Name
Participant Name
*
First
Last
Parent or Guardian Name
Parent or Guardian Name
*
First
Last
Parent or Guardian Phone Number
Parent or Guardian Phone Number
*
-
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-
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Email
*
Gender
*
Male
Female
Prefer not to answer
Birth Date
Birth Date
*
/
MM
/
DD
YYYY
T-Shirt Size
*
Youth Small
Youth Medium
Youth Large
Youth X-Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Did you register for the meal option?
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Yes
No
If yes, are there any dietary restrictions?
Emergency Contact
Emergency Contact
*
First
Last
Emergency Contact Phone
Emergency Contact Phone
*
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-
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Alternate Emergency Contact
Alternate Emergency Contact
*
First
Last
Alternate Emergency Contact Phone
Alternate Emergency Contact Phone
*
-
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-
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List any medical conditions/allergies if applicable. (i.e. diabetes, asthma, allergic to wasp sting).
RELEASE OF LIABILITY, WAIVER OF CLAIMS AND ASSUMPTION OF RISKS AGREEMENT REGARDING:
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Regarding: Selkirk College Saints Golf Camp (the "Event") To: Selkirk College and its governors,and its governors, officers, employees, students and representatives, independent contractors, suppliers, sponsors, heirs, executors, successors and assigns (all of whom are hereinafter referred as the “Releasees”). In this Agreement, the term "Event” shall include all activities or services provided, arranged, organized, conducted, sponsored or authorized by the Releasees and shall include, but is not limited to: all instruction and play on and off the course, travel on bus and recreation break activities and other such activities, events and services in any way connected with or related thereto including the use and occupation of any facilities owned, leased, or licensed by the Releasees. ASSUMPTION OF RISKS The undersigned parent and/or legal guardian and the Participant (collectively, the “Participant Parties”) are aware that the Event involves risks, dangers and hazards including, but not limited to: mechanical failures of equipment, loss of balance; difficulty or inability to control one’s speed and direction; variation or steepness in terrain; rapid or uncontrolled acceleration on hills and inclines; variation in the terrain that may create blind spots or areas of reduced visibility; variation or changes in the surface including rocks, gravel and manmade structures; changing weather conditions; exposure to temperature extremes or inclement weather; travel or transport to and from the sites used for the Event; collision with other persons or vehicles; the failure of others to act safely or within their ability; becoming lost or separated; negligence of other persons; and NEGLIGENCE ON THE PART OF THE RELEASEES, INCLUDING THE FAILURE ON THE PART OF THE RELEASEES TO SAFEGUARD OR PROTECT THE PARTICIPANT FROM THE RISKS, DANGERS AND HAZARDS OF THE EVENT. THE PARTICIPANT PARTIES ARE AWARE OF THE RISKS, DANGERS AND HAZARDS ASSOCIATED THE EVENT AND ACKNOWLEDGE THAT THE PARTICIPANT VOLUNTARILY ELECTS TO PARTICIPATE IN THE EVENT AND THE PARTICIPANT PARTIES FREELY ACCEPT AND FULLY ASSUME ALL SUCH RISKS, DANGERS AND HAZARDS, KNOWN AND UNKNOWN, AND THE POSSIBILITY OF PERSONAL INJURY, DEATH, PROPERTY DAMAGE OR LOSS RESULTING THEREFROM. The Participant Parties understand that all applicable rules for participation in the Event must be followed by the Participant and that RESPONSIBILITY FOR THE PARTICIPANT’S PERSONAL SAFETY REMAINS WITH THE PARTICIPANT. The Participant undertakes and agrees to remove themselves from participation if the Participant feels unable or unfit to safely continue the Event for any reason. RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT The Participant Parties have read the guidelines, rules and regulations issued for the Event, which are understood and the Participant Parties agree to by bound by them. In consideration of the Releasees allowing the Participant to participate in the Event, and for other good and valuable consideration, the receipt and sufficiency of which is acknowledged, the Participant Parties hereby agree as follows: 1. TO WAIVE ANY AND ALL CLAIMS that we have or may in the future have against the RELEASEES AND TO RELEASE THE RELEASEES from any and all liability for any loss, damage, expense or injury, including death, that the Participant may suffer, as a result of his/her participation in the Event, DUE TO ANY CAUSE WHATSOEVER, INCLUDING NEGLIGENCE, BREACH OF CONTRACT, OR BREACH OF ANY STATUTORY OR OTHER DUTY OF CARE ON THE PART OF THE RELEASEES., or in respect of the provision of or the failure to provide any warnings, directions, instructions or guidance as to the Event; 2. TO HOLD HARMLESS AND INDEMNIFY THE RELEASEES for any and all liability for any property damage, loss or personal injury to any third party resulting from the Participant’s participation in the Event; 3. This Agreement shall be effective and binding upon our heirs, next of kin, executors, administrators, assigns and representatives, in the event of the death or incapacity of the Participant Parties; 4. This Agreement and any rights, duties and obligations as between the parties to this Agreement shall be governed by and interpreted solely in accordance with the laws of the Province of British Columbia. This Agreement shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. This Agreement may only be modified in a writing signed by parties. If any of the terms of this Agreement are found by a court of competent jurisdiction to be unenforceable or invalid, the remaining terms shall not be affected. Section headings are for convenience only; and 5. Any litigation involving the parties to this Agreement shall be brought solely within the Province of British Columbia and shall be within the exclusive jurisdiction of the Courts of that province. In entering into this Agreement, the Participant Parties are not relying on any oral or written representations or statements made by the Releasees with respect to the safety of participating in the Event, other than what is set forth in this Agreement. The Participant Parties understand and agree that the Participant’s participation in the Event is conditional upon the execution of this Agreement and waiver of right to sue for any injury, loss or damage as described herein. Participation in the Event is subject to the discretion of the Releasees and is revocable. THE UNDERSIGNED PARENT AND/OR LEGAL GUARDIAN CONFIRM THAT I HAVE READ AND UNDERSTOOD THIS AGREEMENT PRIOR TO SIGNING IT, AND ARE AWARE THAT BY SIGNING THIS AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS THAT I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS, ASSIGNS AND REPRESENTATIVES MAY HAVE AGAINST THE RELEASEES INCLUDING THE RIGHT TO SUE.
Parent/Guardian Signature (if under 19 years of age). Draw your signature into the box below.
*
Draw
or
Type
I understand this is a legal representation of my signature.
Clear
Full Name
I understand this is a legal representation of my signature.
GOLF CAMP PARTICIPANT SIGN IN/OUT PERMISSION FOR 12 YEARS AND OLDER
It is college policy that children may not leave programs unless signed out by a parent, legal guardian, or authorized adult on file. Children may sign themselves out if they are twelve (12) years of age or older and permission has been granted by their parent or legal guardian and permission. If your child is twelve (12) years of age or older and you wish to grant them permission to sign themself out, please read and complete the following. I understand that sign-in and sign-out take place at the program time designated in the Golf Camp Welcome Package and that my child will only be permitted to leave at that pre-determined time. I acknowledge that once my child has signed out of the program, the Selkirk College Athletics and Recreation Department is no longer responsible for the supervision of my child. If a child enrolled in a program is permitted to sign themselves in at the beginning of the day is a no show, the Saints camp procedure will be to contact the parent/guardian at the numbers provided on the Camp Participant Information form. I hereby give permission for my child to:
My child is 12 years old or older and I authorize them to sign themself IN (at the beginning of the day)
Yes
No
My child is 12 years old or older and I authorize them to sign themself OUT (at the end of the day)
Yes
No
My child is under 12 years and the following are the authorized adults who can sign in and sign out my child. (Please list first and last name)
Draw your signature into the box below.
Draw
or
Type
I understand this is a legal representation of my signature.
Clear
Full Name
I understand this is a legal representation of my signature.
PHOTO RELEASE FORM
I authorize Selkirk College Golf Camps run by Selkirk College to video or photograph my child. Selkirk College may use and re-use all or parts of the video or photograph. Selkirk College shall own all right, title and interest in and to the video or photograph including the recordings, to be used and re-used and disposed of without limitation in any media or form of distribution as Selkirk College may solely determine.
Draw your signature into the box below.
*
Draw
or
Type
I understand this is a legal representation of my signature.
Clear
Full Name
I understand this is a legal representation of my signature.
I confirm I have read all of the above and all of the information I have provided is accurate
*
Draw
or
Type
I understand this is a legal representation of my signature.
Clear
Full Name
I understand this is a legal representation of my signature.