Please Print, Sign and bring to practice!
AMATEUR ATHLETIC WAIVER AND RELEASE OF LIABILITY READ BEFORE SIGNING
GUEST PADDLER WAIVER 2018
CLUB NAME: JAX Fire Dragons, Inc.
DATE/S PADDLED: __________
In consideration of being allowed to participate in any way in the UNITED STATES DRAGON
BOAT FEDERATION, (USDBF) and it’s affiliates athletic sports program, related events and
activities, the undersigned acknowledges, appreciates, and agrees that: The risk of injury from the
activities involved in this program is significant, including the potential for permanent paralysis and
death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of
serious injury does exist; and, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS,
both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE
RELEASEES or other and assume full responsibility for my participation; and, I willingly agree to
comply with the stated and customary terms and conditions for participation. If, however, I observe
any unusual significant hazard during my presence or participation, I will remove myself from
participation and bring such to the attention of the nearest official immediately; and, I, for myself and
on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND
HOLD HARMLESS the UNITED STATES DRAGON BOAT FEDERATION and, JAX Fire
Dragons, All Wet Sports their officers, directors, employees, servants, commissioners, volunteers,
officials, agents, and/or employees, steerers, coaches, other participants, municipalities, sponsoring
agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct
club & activities (“RELEASEES”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY,
DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE
OF THE RELEASEES OR OTHERWISE.
I am also aware that photographs taken during club activities may be posted to the club web site, or
social networking site and may be used for publicity purposes only by the club.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY
UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT,
AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
__________________________________ _________________________ Date: ______
(Guest Name – Please Print) (Signature)
_________________________________________________________ Age: __________
I understand that I can paddle with the above club 3 times as a guest after which I must become a regular
member to be covered under the club liability coverage.
FOR PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT THE TIME OF REGISTRATION)
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 Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to
indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child’s involvement or
participation in these programs as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE
RELEASEES, to the fullest extent permitted by law.
X__________________________ _________________________________ ________
(Parent/Guardian Signature) (Emergency phone number) Date
Print Name: ____________________________________________________