Please note every that every participant in the Spitfire Challenge is required to fill in this liability waiver form or they can not play, officiate or enter the playing floor of the gymnasium, use the buses or attend the hospitality night.
2011 Spitfire
Challenge XXIX
July 29, 30, 31 & August 1,
2011
Toronto, Ontario, Canada
SPITFIRE CHALLENGE Warning, Waiver, Release of Liability Form
In consideration of being permitted to participate in any way, including using any busing provided before, during and after the Spitfire Challenge basketball tournament. Any travel associated with the Spitfire Challenge wheelchair basketball tournament including: bussing to and from the Toronto Pearson International airport, Delta hotel located at 5444 Dixie Road, Mississauga ON L4W 2L2, the gymnasium located at 590 Rathburn Road Toronto and named the Etobicoke Olympium, any tourist activities and related events and including the hospitality night of the Spitfire Challenge XXIX wheelchair basketball tournament
I hereby :
1. Acknowledge that I am familiar with the sport of wheelchair basketball and understand the rules governing the sport of wheelchair basketball and any changes in the rules as presented in the Spitfire Challenge, and
2. Agree that, prior to participating as a Player, coach, team support staff, game official or volunteer in any capacity I will inspect the gymnasium, facilities, equipment, competition pools, divisions or conferences, and the elimination or scoring system to be used, and if I believe anything is unsafe or beyond my capability, I will immediately advise my coach, supervisor and/or a tournament official of such conditions and refuse to participate, and
3. Acknowledge and fully understand that if participating as a player, coach, manager, a member of a team support staff or entourage, game official or volunteer and may at any time access the gymnasium playing floor or surrounding area. I will be engaging in or be exposed to a contact sport and that the risk of injury from the activities involved in this tournament is significant, which might result in serious injury, including the potential for permanent disability and even death and severe social and economic losses due not only to my own actions, inactions or neglect, but also the actions, inactions or negligence of others, the rules of the sport of wheelchair basketball, or conditions of the premises or of any equipment used. Further I acknowledge that there may be other risks not known to me or not reasonably foreseeable at this time, Furthermore if a playing participant or game official I certify that I am medically fit to participate/officiate in these strenuous activities and have no medical conditions which would restrict my participation, and
4. Knowing the risks involved in the sport of wheelchair basketball, I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the Spitfire Wheelchair Sports Association, The Spitfire Challenge wheelchair basketball tournament, referees, game officials, volunteers, team members, organizers, agents, other players or participants, sponsoring agencies, sponsors, advertisers, the Dennys bus company and its employees, The Delta Hotel, The Etobicoke Olympium and the Emergency Patrol, and if applicable, owners and leasers of premises used to conduct the Spitfire Challenge tournament program and assume full responsibility for my participation, I accept personal responsibility for the damages following such injury, permanent disability, or death, and
5. I for myself and on behalf of my heirs, assigns, personal representatives and next of kin, hereby release and hold harmless the releases, with respect to any and all injury, disability, death, or loss or damage to person or property, whether caused by negligence of the releases or otherwise, and
6. I further agree to irrevocably grant the Spitfire Wheelchair Sports Association and the Spitfire Challenge wheelchair basketball tournament and future Spitfire Challenge wheelchair basketball tournaments and their agents, affiliates or assigns, the perpetual unlimited world-wide and royalty free rights to record, reproduce, broadcast, exhibit, publish, sell, distribute or use in any way whatsoever, my name and likeness in any media, whether now known or hereafter developed, in connection with my attendance and participation in the Spitfire Challenge wheelchair basketball tournament including without limitation a videotape recording of such performance and/or event. I agree that I shall have no claim, title or interest in my attendance or participation or any materials produced hereunder.
I HAVE READ THE WARNING, WAIVER, AND RELEASE, PRINTED ABOVE ON THE WEBSITE or ON THE OTHER SIDE OF THIS PAGE AND UNDERSTAND THAT I GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND KNOWING THIS, SIGN IT VOLUNTARILY. I AGREE TO PARTICIPATE KNOWING THE RISKS AND CONDITIONS INVOLVED AND DO SO ENTIRELY OF MY OWN FREE WILL. I AFFIRM THAT I AM AT LEAST 18 YEARS OF AGE, OR, IF I AM UNDER 18 YEARS OF AGE, I HAVE OBTAINED THE REQUIRED CONSENT OF MY PARENTS/GUARDIAN AS EVIDENCED BY THEIR SIGNATURE BELOW.
PARTICIPANTS INFORMATION
Please note Failure to fully complete all requested information will eliminate this participant from participating in the 2008 Spitfire Challenge.
FULL NAME (print last name)
(print
first name)
STREET ADDRESS
CITY
..State/Prov
COUNTRY
.
HOME PHONE
AGE
..
GENDER:.................
Birthdate: DAY ..Month .Year....................
PARTICIPANTS SIGNATURE:........................................................................................................
DATE:..........................................................
TEAM Participating with or
Volunteer:..........................................................
Parents/Guardian information
FULL NAME (print last name)
(print
first name)
STREET ADDRESS
CITY
..State/Prov
COUNTRY
.
HOME PHONE
BUSINESS
PHONE...................................................
This is to certify that I, as parent/guardian with legal responsibility for this
participant, do consent and agree to his/her release, as provided above of all the
Releases, and, for myself, my heirs, assigns, and next of kin, I release and
agree to indemnify and hold harmless the Releases from any and all liabilities
incident to my minors childs involvement or participation in these
programs as provided above, even if arising from their negligence, to the fullest
extent permitted by law. I have instructed the minor participant as to the
above warnings and conditions and their ramifications.
Parent/Guardian: (print last name) (print first name)....
Parent/Guardians
Signature:.......................................................................................................
DATE:.....................................................................................