General Medical Liability Waiver
Download Alberta 55 plus Liability Waiver
Alberta Senior Citizens Sport & Recreation Association (Alberta 55 plus) RELEASE OF LIABILITY, WAIVER OF CLAIMS, ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT BY SIGNING THIS DOCUMENT, YOU WILL WAIVE CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE. PLEASE READ CAREFULLY!
In full, or partial, consideration for allowing me to participate in all related events and activities sponsored by the Alberta Senior Citizens Sport and Recreation Association (Alberta 55 plus) and its 8 (eight) Zones; Zone 1 – Sunny South Seniors Sport & Recreation Association, Zone 2 – Big Country Seniors Sport Society, Zone 3 – Calgary 55 Plus Games Association, Zone 4 – Silver Willow Association, Zone 5 – Black Gold/Yellowhead Senior Games Association, Zone 6 – Marigold Seniors Recreation Society of Edmonton, Zone 7 – Lakeland Senior Games Association, Zone 8 – The Mighty Peace Sport and Recreation Association, Host Societies for Winter and Summer Games, I hereby warrant and agree that:
- I am familiar with and accept that there is the risk of serious injury and death in participation in any form of sports; and
- I have satisfied myself and believe that I am physically, emotionally and mentally able to participate in this program; and that my equipment is mechanically fit and appropriate for use in this program; and
- I understand that all applicable rules for participation must be followed and that always, the sole responsibility for personal safety remains with me; and
- I will immediately remove myself from participation, and notify the nearest official, if at any time I sense or observe any unusual hazard or unsafe condition or if I feel that I have experienced any deterioration in my physical, emotional or mental fitness for continued participation in the program; and
- I give my permission for the free use of my name and picture in broadcast, telecast or written accounts for all Alberta 55 plus sanctioned or related events.
I UNDERSTAND AND AGREE, ON BEHALF OF MYSELF, MY HEIRS, ASSIGNS, PERSONAL REPRESENTATIVES AND NEXT OF KIN THAT MY EXECUTION OF THIS DOCUMENT CONSTITUTES:
- AN UNQUALIFIED ASSUMPTION BY ME OF ALL RISKS associated with my participation in any Alberta 55 plus sanctioned event even if arising from negligence or gross negligence, including any compounding or aggravation of injuries caused by negligent rescue operations or procedures, of any one or more of the event organizers, the event venues, and any and all persons associated therewith or participating therein in any manner or fashion whatsoever; and
- FULL AND FINAL RELEASE AND WAIVER OF LIABILITY AND ALL CLAIMS that I have or may in the future have against Alberta Senior Citizens Sport & Recreation Association (Alberta 55 plus), the event venues, and their respective directors, officers, employees, servants, agents and representatives, all advertisers, volunteers, and all others participating in the program, (all of whom are collectively referred to as the Releasees) from any and all liability for any loss, damage, injury or expense that I may suffer as a result of my use of or my presence at the event facilities or my participation in any part of, or presence at, the program due to any cause whatsoever, INCLUDING NEGLIGENCE, GROSS NEGLIGENCE, BREACH OF CONTRACT, OR BREACH OF ANY STATUTORY OR OTHER DUTY OF CARE, INCLUDING ANY DUTY OF CARE OWED UNDER THE RELEVANT OCCUPIERS LIABILITY ACT ON THE PART OF THE RELEASEES.
- AN AGREEMENT NOT TO SUE THE RELEASEES for any loss, injury, costs or damages of any form or type, howsoever caused or arising, and whether directly or indirectly from my participation in any aspect of the program; and
- AN AGREEMENT TO SAVE and HOLD HARMLESS the RELEASEES, and each of them, from any litigation expense, legal fees, liability, damage, award or cost, of any form or type whatsoever, they may incur due to any claim made against them or any one of them whether the claim is based on the negligence or the gross negligence of the Releasees or otherwise, whether directly or indirectly from any participation in any aspect of the program; and
- AN AGREEMENT that this document be governed by the laws, and in the courts, of the Province in which the program is held. I HAVE READ AND UNDERSTAND THIS AGREEMENT AND I AM AWARE THAT BY SIGNING THIS AGREEMENT I AM WAIVING CERTAIN SUBSTANTIAL LEGAL RIGHTS WHICH I AND MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS AND ASSIGNS MAY HAVE AGAINST THE RELEASEES. I SIGN THIS DOCUMENT KNOWING AND APPRECIATING ITS CONSEQUENCES.
CovId 19 Coronavirus Liability Waiver
Alberta55 plus Medical Waiver (Covid-19 Coronavirus inclusive)
ACKNOWLEDGEMENT AND ASSUMPTION OF RISK
I UNDERSTAND AND AGREE that there is potential risk of contracting the COVID – 19 Coronavirus, as well as incurring an injury while training and participating in this event. I further understand and agree that participating in _______ is a potentially dangerous activity. Bumps, bruises, cuts, scrapes, scratches, and soreness are commonplace, and most participants will encounter this sort of minor injury from time to time. More serious injuries are possible, including sprains, strains, twists, cramps, and injuries of similar magnitude. The possibility of more serious injury exists, including fractured bones, broken bones, torn ligaments, concussions, though most participants do not encounter such serious injuries. There remains, despite safety precautions, the remote possibility of crippling or death. I FREELY ACCEPT AND FULLY ACKNOWLEDGE all such risks, dangers and hazards, resulting from my participation in the Alberta55Plus _________________ event.
I am also aware that I should discuss my participation in this event with my physician to determine the effect on my current health, especially as it relates to the COVID 19 Coronavirus. It is my right and responsibility as a participant to immediately remove myself from participation in the event and notify the nearest official, if at any time I sense any unusual hazard, or unsafe condition, or if I feel that I am physically, emotionally, or mentally unfit for continued participation in the event. I have read and understand the above statement of risk. I assume full responsibility for my own safety, and I understand and accept the risks involved with my participation. I also expect, understand and accept the fact that there will be participants at the event that have been vaccinated, not vaccinated yet or those who choose not to be vaccinated at all.
RELEASE OF LIABILITY, WAIVER OF CLAIMS, AND INDEMNITY AGREEMENT
I hereby agree as follows:
TO WAIVE ANY AND ALL CLAIM that I have or may in future have against Alberta55Plus, its officials, members, agents, directors, and representatives, and its President and other participants (all of whom are hereinafter collectively referred to as “Releasees”).
I HAVE READ, understood and agree with the statements in the ACKNOWLEDGEMENT AND ASSUMPTION OF RISK portion of this document, and by assuming and acknowledging this risk, I completely absolve all RELEASEES from any and all liability for loss, damage, injury or expense that I
may suffer; that a third party may suffer; or, that my next of kin may suffer as a result of my participation in this Alberta55Plus________ event, offered by the Releasees, DUE TO ANY CAUSE WHATSOEVER. I acknowledge my responsibility to ensure adequate medical personal health, dental and accident insurance coverage, as well as protection of my personal possessions.
IN ENTERING INTO THIS AGREEMENT, I am not relying upon any oral or written representations or statements made by the Releasees other than what is set forth in this Agreement.
I HAVE READ AND UNDERSTOOD THIS AGREEMENT AND I AM AWARE THAT BY SIGNING THIS AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS OR ASSIGNS MAY HAVE AGAINST THE RELEASEES.
Signed this _______________day of __________________________, 2020
Signature of Participant Witness to Signature
Printed Name of Participant Printed Name of Witness
