Canoe Polo Player Entry

This form must be completed and submitted for each individual player

If a player is under 18 this form must be completed by a parent or guardian

Player Name

Team

Age

Gender

Team Captain

Player Identification Number

Paddle UK Number

Paddle UK Expiry Date

Ability

Medical Information

Allergies / Medical Conditions

Emergency Contact Details

Emergency Contact Name

Emergency Contact Phone

WAIVER OF LIABILITY AND RELEASE OF CLAIMS

In consideration of being allowed to participate in the activities organized by Viking Kayak Club (VKC), I, the undersigned, hereby acknowledge and agree to the following terms and conditions:

Assumption of Risks: I understand that participating in canoeing and related activities involves inherent risks, including but not limited to the risk of injury, drowning, and property damage. I voluntarily assume all such risks and acknowledge that they are an inherent part of the activity.

Physical Condition: I certify that I am in good physical condition and have no medical conditions that would prevent my safe participation in canoeing activities. I agree to inform Viking Kayak Club (VKC) of any changes in my health that may affect my ability to participate.

Rules and Guidelines: I agree to abide by all rules, guidelines, and safety instructions provided by Viking Kayak Club (VKC) and its representatives. I understand that failure to comply with these rules may result in my removal from the activity.

Waiver of Liability: I hereby waive, release, and discharge Viking Kayak Club (VKC), its officers, directors, instructors, volunteers, and any other representatives from any and all claims, liabilities, demands, actions, or causes of action that may arise out of or are in any way connected with my participation in canoeing activities.

Indemnification: I agree to indemnify and hold harmless Viking Kayak Club (VKC), its officers, directors, instructors, volunteers, and any other representatives from any and all claims brought by me or a third party arising out of my participation in canoeing activities.

Emergency Medical Treatment: In the event of an injury or medical emergency, I authorize Viking Kayak Club (VKC) and its representatives to seek and consent to emergency medical treatment on my behalf.

Photographic Release: I grant Viking Kayak Club (VKC) permission to use photographs or videos of me taken during canoeing activities for promotional or educational purposes without compensation.

I agree to all of the statements above

Full Name

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