SSCA_Volunteer Waiver for Pump Track
This waiver needs to be filled out before each day of work at the Pump track.
Sign in to Google to save your progress. Learn more
Names of all persons over age 18 years completing waiver (sorry children are not allowed onsite at this time) (referred to herein as "Participants"): *
Email Address *
Phone Number *
Postal Code *
Today's Date: *
MM
/
DD
/
YYYY
RELEASE OF LIABILITY, WAIVER OF CLAIMS, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT (hereinafter referred to as the “Release Agreement”) BY COMPLETING THIS DOCUMENT YOU ARE GIVING UP CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE OR CLAIM COMPENSATION FOLLOWING AN ACCIDENT:    PLEASE READ CAREFULLY!
Clear selection
Name of Event ("Pump Track Event") *
COVID-19 WAIVER:  Please read all the COVID-19 List of Symptoms from AHS  COVID-19 Alberta Health Daily Checklist below .
Captionless Image
Clear selection
Do you agree with the following statement:  I have read the above COVID-19 List of Symptoms from AHS and answered "NO" to all of the statements on the COVID-19 Alberta Health Daily Checklist? *
Required
IF YOU ANSWERED “YES” TO ANY OF THE CATEGORIES OF QUESTIONS ON THE CHECKLIST YOU MUST STAY HOME AND FOLLOW THE DIRECTIONS OF AHS. *
COVID-19 WAIVER AND RELEASE:  CONTRACTING THE COVID-19 VIRUS CAN RESULT IN SERIOUS ILLNESS OR EVEN DEATH.  THE COVID-19 VIRUS CAN BE TRANSMITTED BY ASYMPTOMATIC PEOPLE. THE SILVER SPRINGS COMMUNITY ASSOCIATION IS FOLLOWING PUBLIC HEALTH ORDERS AND GUIDANCE BUT THERE CAN BE NO ASSURANCE THAT THE VIRUS WILL NOT BE CONTRACTED ONSITE OR AT OUR FACILITY OR DURING THE PUMPTRACK EVENT. PLEASE UNDERSTAND THAT YOU ARE PARTICIPATING IN THE PUMP TRACK EVENT AT YOUR OWN RISK. By completing and submitted this declaration you agree to the statements within. *
I have read and understand the the Silver Springs Community Association’s COVID-19 rules and I agree to comply with them.  I fully understand that I may contract the Covid-19 virus even if I follow all the rules, and I hereby release, waive and hold the Silver Springs harmless from any responsibility should I suffer illness, loss or damage while participating in the activities listed herein.
Clear selection
WAIVER OF CLAIMS ARISING FROM PUMP TRACK EVENT(S):  I am aware that participating as a volunteer in the Pump Track Event(s) involves many inherent physical risks, dangers and hazards, including but not limited to: strenuous physical activity which may or may not be familiar; working with tools and equipment; working around other participants who may not be accustomed to this kind of labour or the use of tools and equipment associated with it; exposure to rock, earth, ice or other natural objects such as trees, tree limbs, tree stumps, debris, and deadfall; working in or close to holes and depressions on or around the trail or surface;  extreme weather, changing weather conditions; changes or variations in the terrain which may create blind spots or areas of reduced visibility; standing water, hills, tripping hazards on footpaths and trail-less terrain, possible  impacts or collisions with bikes, vehicles and other trail users; risks associated with using personal protective equipment;  negligence of other mountain bikers and trail users; AND NEGLIGENCE ON THE PART OF THE RELEASEES ("defined below"), INCLUDING THE FAILURE BY THE RELEASEES TO SAFEGUARD OR PROTECT ME FROM THE RISKS, DANGERS AND HAZARDS REFERRED TO ABOVE. I agree that in the event of an accident, I may be able to obtain treatment at the Pump Track Event site, or others may determine that calling 9-1-1 for medical treatment is prudent and appropriate, though the response may be delayed.   *
Do you have protective equipment below to bring for build days?
I, and my heirs, successors, and assigns (each a “Releasor”) hereby release, indemnify, defend, and hold harmless the SSCA, its officers, directors, employees, successors, assigns, agents, and employees (each a “Releasee”), from all claims, damages, actions, judgments, obligations, and liabilities of every nature (including without limitation legal fees and costs fees), known or unknown, foreseeable or unforeseeable, in any manner related to the Pump Track Event(s), including, without limitation, liability for personal injury or death, property damage, and loss of income.  I ACKNOWLEDGE THAT I HAVE THE RIGHT TO RETAIN A LAWYER TO REVIEW THIS DOCUMENT, AND THAT THE FACT THAT SSCA HAS DRAFTED THIS WAIVER AND RELEASE OF LIABILITY SHALL NOT BE CONSIDERED IN CONSTRUING AN AMBIGUITY IN A PARTICULAR PROVISION AGAINST SSCA. This Waiver and Release of Liability shall be construed in accordance with and shall be governed by the laws of the Province of Alberta, Canada, without giving effect to that province’s rules relating to conflicts of laws.
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Silver Springs Community Association. Report Abuse