Relationship to Registrant(s) I am the registrant Mother Father Guardian/Caregiver Other
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How many people are you registering? 1 2 3 4 5
from policies (no
Emergency Contact Phone
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Waiver & Assumption of Risks * AXÉ SOCIETY FOR CAPOEIRA PROGRAM
ASSUMPTION OF RISK, WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT
1. ASSUMPTION OF RISK
I am aware that in consideration of me and/or my child/ren participating in the activities of Axé Society for Capoeira Program, and in any activities arising in connection with or in preparation for the Program, that the activity(ies) carries many inherent risks, including but not limited to:
General: Possible vandalism, theft, damage, or loss of personal property. All manners of harm, injury, illness, death, or property damage resulting from: use, misuse, non-use, or failure of any equipment present at the various locations/facilities used by Axé Society for Capoeira; travel by motor vehicle, bus, or any other means of transportation to, from, or during the activity(ies); negligence on the part of Axé Society for Capoeira and its members, officers, employees, students, agents, volunteers, and independent contractors; forces of nature or other causes.
Axé Society for Capoeira strongly recommends consulting a physician before participating in any physical activity, or if you or your child have any pre-existing medical condition that participation may affect.
Program-Specific: Harm, injury, illness, death, or property damage resulting from: contact with participants, volunteers, employees, or other people; increased cardiovascular load, which may result in dizziness, shortness of breath, or in rare cases a cardiac event; muscular injuries such as sprains, strains, bone injuries, fainting, chest discomfort, leg cramps, or nausea; heat-related injuries including burns, cramps, exhaustion, or heat stroke; participating in activities beyond one's own abilities; sudden equipment malfunction; allergic reactions to any allergen present on the premises; structural falls or collapses; and use of equipment beyond one's own abilities.
I voluntarily assume all such risks, dangers, and hazards, and the possibility of personal injury, death, property damage, or loss arising from them.
2. MY OWN RELEASE OF LIABILITY, WAIVER OF CLAIMS, AND INDEMNITY
In consideration of my own participation in the Axé Society for Capoeira Program, I, personally, agree as follows:
I WAIVE ANY AND ALL CLAIMS that I have or may in the future have against Axé Society for Capoeira and its members, officers, employees, students, agents, volunteers, and independent contractors (collectively, "the Members");
I RELEASE THE MEMBERS from any and all liability for loss, damage, injury, or expense that I may suffer, or that my next of kin may suffer, arising from my participation in the Program, due to any cause whatsoever, including negligence, breach of contract, or breach of any statutory or other duty of care, including any duty of care owed under the Occupiers' Liability Act, RSA 2000, c O-4, as amended, on the part of the Members;
I AGREE TO HOLD HARMLESS AND INDEMNIFY THE MEMBERS from any and all liability for damage to property or personal injury to any third party resulting from my own participation in the Program.
If I am supplying my own equipment, I am responsible for ensuring it is safe, well maintained, and meets the standard required for the activity. I understand the Members accept no responsibility for incidents arising from the use or misuse of my equipment.
3. PARTICIPATION OF MY CHILD/REN — ASSUMPTION OF RISK AND INDEMNITY
As the parent or legal guardian of the participating child/ren named on this registration, I confirm that I have read and explained the risks described in Section 1 to my child/ren, to the extent age-appropriate, and I consent to my child/ren's participation in the Program with full knowledge of those risks.
I AGREE TO INDEMNIFY AND HOLD HARMLESS THE MEMBERS from and against any claim, demand, lawsuit, cost, or expense (including legal fees) brought by or on behalf of my child/ren arising from their participation in the Program, to the fullest extent permitted by law. I understand this indemnity does not eliminate my child/ren's own independent legal rights, but it means I personally agree to bear the cost if such a claim is made, except where prohibited by law or arising from gross negligence or willful misconduct on the part of the Members.
4. EMERGENCY MEDICAL TREATMENT
If I am the participant, I authorize Axé Society for Capoeira staff to secure emergency medical treatment on my behalf, at my expense, in the event I am unable to consent at the time (for example, due to loss of consciousness or incapacity), and to contact the emergency contact provided on this registration if needed.
If my child/ren is/are the participant(s), I authorize Axé Society for Capoeira staff to secure emergency medical treatment for my child/ren, at my expense, in the event I cannot be reached in a timely manner.
This authorization does not obligate the Members to provide medical care and is intended solely to permit staff to act in the participant's best interest during an emergency.
5. GENERAL TERMS
This agreement is binding on me, my child/ren, and our respective heirs, next of kin, executors, administrators, assigns, and representatives, in the event of death or incapacity.
This Waiver is governed by the laws of the Province of Alberta and the federal laws of Canada, as applicable. The courts of Alberta have exclusive jurisdiction over any claim, dispute, or action arising from this Waiver, and the parties attorn to that jurisdiction.
If any portion of this agreement is found unenforceable by a court, the remaining portions remain in full force and effect.
In entering this agreement, I confirm I am not relying on any oral or written representation other than what is set out here.
I CONFIRM THAT I AM 18 YEARS OF AGE OR OLDER, that I have read and understood this agreement, and that I am aware that by signing, I am waiving certain legal rights, including the right to sue, that I, or my heirs, next of kin, executors, administrators, and assigns may have against the Members. I understand that my child/ren's own independent legal rights are addressed separately in Section 3.