Surfer Registration and Release Flat water clinic

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Event Timing: January 9 4-6pm
Event Address: Wabasso Causway Contact us at (772)646-2009 or treasurecoastclub@gmail.com

Email *

Name (First and Last) *

Email *

Emergency Contact and phone Number

Address of Surfer (Address, City, State, Zip)

Age of Surfer

Medical Conditions?

Height

Weight

Shirt Size

XXL

Clear selection

Surfing Experience?

I agree to assume all risks to participation in surfing related activities associated with Brando’s Surf School, LLC and Treasure Coast Board Rider Club INC. I hereby grant permission for myself or my child to attend Brando’s Surf School, LLC and Treasure Coast Board Rider Club INC.and participate in its activities. I hereby release Brando’s Surf School, LLC and Treasure Coast Board Rider Club INC.from any and all liabilities, claims, actions, damages, costs and/or expenses, arising from or in any way connected with my participation in all surfing related activities conducted by Brando’s School, LLC and Treasure Coast Board Rider Club INC. I hereby agree that Brando’s Surf School, LLC and Treasure Coast Board Rider Club INC. its owners, officers and instructors, are not in any capacity personally responsible or liable for any injuries or damage resulting from my participation in any Brando’s Surf School, LLC and Treasure Coast Board Rider Club INC. programs. I fully understand and acknowledge that surfing, skateboarding, body boarding, skim boarding, Indoboarding and crossing A1A are inherently dangerous activities. I acknowledge and assume any and all risks associated with the presence of any and all sea life that may be in the ocean or on the beach.

I do

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I hereby give my consent and approval Right to Photograph to Brando’s Surf School, LLC and Treasure Coast Board Rider Club INC. they shall have the right, without obtaining my further approval, to photograph, take motion pictures of, televise, or reproduce in any manner or through any media, images of myself, my child, and my legal guardians. Brando’s Surf School, LLC and Treasure Coast Board Rider Club INC. have the right to display, use, sell or license any such pictures or other reproductions for any purposes, commercial or otherwise, without monetary compensation to myself, my child or my legal guardian.

I do

I do not

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I hereby authorize any physician or lifeguards selected by Brando’s Surf School, LLC and Treasure Coast Board Rider Club INC. to order and conduct medical or surgical procedures deemed necessary and authorize any Brando’s Surf School, LLCa nd Treasure Coast Board Rider Club INC. personnel to conduct any minor medical First Aid that may be required for my child, myself or my legal guardian for myself, my child or my legal guardian in an emergency situation. I understand that I will be responsible for all hospital, laboratory and doctor fees.

I do

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I verify that I am in good health and am fully capable of participating in any and all strenuous activities associated with any Brando’s Surf School, LLC and Treasure Coast Board Rider Club INC. I fully understand that each participant must be a competent swimmer and acknowledge that I am competent swimmer.

I do

Other:

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I as the parent or legal guardian give my permission for my child or Ward to participate in Brando’s Surf School, LLC and Treasure Coast Board Rider Club INC activities. I do understand and acknowledge the above stated risks associated with my child or Ward’s participation in surfing related activities with the Brando’s Surf School, LLC. and Treasure Coast Board Rider Club INC.

I do

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Parent or Legal Guardian Signature

Date

YYYY

By checking the Box below, I agree, I agree to assume all risks to participation in surfing related activities associated with Brando’s Surf School, LLC. and Treasure Coast Board Rider Club INC have read and understand all sections above.

I do

Students’ Signature

Students’ Signature Date

YYYY

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