Heart of Surfing Participation 2023
***Please fill out the Participation Agreement below.
RELEASE OF LIABILITY, VOLUNTARY ASSUMPTION OF RISK AND INDEMNITY AGREEMENT
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Email *
*This is not a ticket* Please visit www.heartofsurfing.org and Click on Events to find the event you'd like to attend. In the description, click on the Eventbrite link to Order Tickets. Filling out this form does not reserve you a ticket. *
Required
Participant's Name *
Participant's Date of Birth *
MM
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DD
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YYYY
Guardian/Support/Family Member's Name *
Emergency Contact Number *
Which event dates do you plan to attend?
Type your name below to agree the Guardian is allowing the participant to partake in all events sponsored by Heart of Surfing *
Type your name below to agree the participant will have supervisions/support provided by the guardian at all times at all events sponsored by Heart of Surfing *
Type your name below to agree the guardian WAIVES, RELEASES, AND FOREVER DISCHARGES any and all claims, liabilities, losses, demands, damages, costs, expenses, lawsuits, causes of action and judgement that he or she, the participant, or any other parent/guardian/support of the participant now or hereafter may have or claim to have against Heart of Surfing resulting only from any inherent risk involved with an Heart of Surfing event. Examples of such INHERENT RISKS include, but are not limited to: physical trauma, strains, bruises, sprains, muscle tears, broken bones, sunburn, negligent or intentional acts of the participant or other participants and/or more serious injuries or illness, including cardiac injuries and heart attacks, permanent disability, paralysis, and death. INHERENT RISKS additionally include a failure by any Heart of Surfing event provider to warn guardian or participant of a specific INHERENT RISK. That guardian acknowledges, understands, and appreciates that there are INHERENT RISKS involved in a Heart of Surfing event *
Type your name to agree due to COVID, to the guardians knowledge their participant is healthy and had not been expose to COVID-19 or experienced any symptoms. *
Type your name below to agree Heart of Surfing Volunteers are wonderful, but they need family/support input in times of extreme behaviors. You know what works best with your participant *
Type your name to agree guardians acknowledge that they have authority to immediately terminate the participant's participation in any Heart of Surfing event if the guardian observes anything deemed unsafe and that the guardian agrees to immediately alert Heart of Surfing personnel *
Type your name below to agree that guardians further acknowledge that, to the best of their knowledge, the participant knows how to swim and maintain buoyancy in the open water, or agrees to wear a life vest, is in good health and does not have any health or mental/physical impairments or conditions that would be aggravated by participating in any Heart of Surfing event or that make participation unsafe or otherwise inappropriate for the participant, or other participants *
Type your name to agree the guardian agrees that the participant/support/family members will be allowed to be photographed and videotaped during participation. Heart of Surfing has permission to use in all forms of media, including advertising, publications, websites, internet, and social media *
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