Please print out this form and bring it, filled out, to your next practice with us.
Dues are $30 annually. Cheques are payable to the Edmonton Dragon Boat Racing Club
Contact us directly by phone: 427-6515 in Edmonton, or email: edmdragonboat@hotmail.com
Registration Year:
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Initial Application or Renewal?
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Date:
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First name and
last name:
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Mailing Address:
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Mailing Address,
City/Prov/Postal Code:
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Work Phone:
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Home Phone:
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Email address(es):
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Special Requests
or Medical Considerations: please describe any previous paddling experience you
have, or what physical conditions of yours that your coaches should be made aware of:
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Membership Category: single or
family?
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Additional Family
Member Names:
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Release and
waiver: In consideration of membership and permission to participate in Dragon Boat RAcing granted me or my son/daughter/ward by the Edmonton Dragon Boat Racing Club, a non-profit organization, I hereby release and discharge the Edmonton Dragon Boat Racing Club, directors, coaches, members, agents, officers, and employees from all claims, demands, actions, judgements, and executions which the undersigned's heirs, executors, administrators, or assigns may have, or claim to have, for all personal injuries, known and unknown, and injuries to property, real or personal, caused by, or arising, ou of the participatipation in the activity of dragon boat training and/or racing. I, the undersigned, fully understand that this sport activity has inherent risks involved, and I am fully aware of the nature of these risks, but waive rights, claims, cause of action, etc as heretofore enumerated, and do hereby assume the risk. I, the undersigned, have this Release/WAiver, and understand all of its terms and conditions. I execute it voluntarily and with full knowledge of its significances.
IN WITNESSWHEREOF, I have executed this release at
____________________________, on the
________ day of __________________ of the year ____________ |
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Printed Name of
Applicant:
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Signature of Applicant:
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Witnessed by:
(printed name)
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Signature of Witness:
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Parent or Guardian, if athelete
is under legal age:
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