2024 Waivers Please fill out all information below for the Regina Riot 2024 Season.Player Name (Format: First Middle Last) EX: Sally Anne Smith(Required) Date of Birth (Format: DD/MM/YY)(Required) Email(Required) Phone number (Format: XXX-XXX-XXXX)(Required) Home address(Required) Emergency Contact(Required) Emergency Contact relationship(Required) Emergency Contact Phone Number (Format: XXX-XXX-XXXX)(Required) Health Card Number(Required) Family Physician(Required) Physician address or office(Required) Please list any conditions or allergies that you have that we should be awareof (asthma, diabetes, etc.)(Required) Self-IdentificationThe following questions are not mandatory to answer. The data is used for multiple things such as: grant opportunities and to better understand our athlete base. More than one answer can be chosen for each question. What is your gender identity? Woman Man Non-binary Transgender Prefer not to answer What is your sexual orientation? Asexual Bisexual/pansexual/demisexual Heterosexual/straight Lesbian/gay Queer Prefer not to answer What racial identity best describes you? Arab/middle eastern/west eastern Black Indigenous Latino/latina/latinx Native Hawaiian/Pacific Islander South Asian/Indo-carribean White Prefer not to answer Do you identify as a person with a disability? Yes No Prefer not to answer Regina Riot Terms and Liability Waiver 2024RELEASE FROM LIABILITY I agree to assume all risks and hazards incidental to participation in tackle football. I do hereby waive, release, absolve, indemnify, and agree to hold harmless, Regina Riot Football Inc. the officers, directors, coaches, sponsors, volunteers, individual chapters, participants, and persons transporting myself to and from any team activities, for any claim arising out of an injury, whether the result of negligence or any other cause.(Required) I agree.MEDICAL RELEASE I hereby grant permission to Regina Riot Football Inc. to administer first aid, secure proper treatment, and/or hospitalize myself in case of emergency, provided I am unable to communicate with them, and according to their best judgement.(Required) I agree.PHOTOGRAPH RELEASE I hereby grant permission to Regina Riot Football Inc. to take photographs or video of myself at Team events for promotional, website and social media use and to tag me in posts on social media.(Required) I agree.Medical Certificate & Waiver I am satisfied that I/my daughter is in good health to take part in strenuous activities. She gives/I give my permission to participate in those approved physical activities leading up to and including the Regina Riot Football practices and camps, and I absolve the Regina Riot Football Club and/or any of its staff,directors, executive, associations, members, volunteers or sponsors including the WWCFL & Football Saskatchewan from any and all liability whatsoever in relation to me/my daughter being examined by a physician for all football activities. I also agree with the need to be/have my daughter examined by a physician following an illness or injury to re-establish a bill of good health, and that this or any other medical examination is my sole responsibility.(Required) I agree.Physical Examination Certificate I certify that I have undergone a physical examination conducted by registered physical physician, in this current calendar year. The physician certifies that they have found me in good health and without any objective signs of any physical disability and may participate in the strenuous activities associated with the Regina Riot Football club practices/training camps and the WWCFL season.(Required) I agree.Values and Expectations I have read and understand the Values and Expectations document provided. I acknowledge and agree to the values and expectations the Regina Riot have of me.(Required) I agree.DECLARATION I hereby acknowledge with indicating "I agree" below that I have read, understood, accept and agree to all terms and conditions of the Regina Riot. Acknowledging that I will not hold the Regina Riot football team, members, coaches or staff responsible for injuries of damages that may occur.(Required) I agree.2024 WESTERN WOMEN’S CANADIAN FOOTBALL LEAGUE RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT (To be executed by Participants over the Age of Majority)The following waiver is required by the league. If you are under 18 years old, you must use the copy shared on slack (signature required from a guardian). Disclaimer(Required)1. This is a binding legal agreement. Clarify any questions or concerns before signing. As a participant in the sport of football and the spectating, orientation, instruction, activities, competitions, programs, and services of Western Women’s Canadian Football League and Regina Riot (collectively the “Activities”), the undersigned acknowledges and agrees to the terms outlined in this document. Disclaimer 2. The Western Women’s Canadian Football League, Regina Riot and their respective Directors, Officers, committee members, members, employees, coaches, volunteers, officials, participants, agents, sponsors, owners/operators of the facilities in which the Activities take place, and representatives (collectively the “Organization”) are not responsible for any injury, personal injury, damage, property damage, expense, loss of income or loss of any kind suffered by a Participant during, or as a result of, the Activities, caused in any manner whatsoever including, but not limited to, the negligence of the Organization. I agreeDescription and Acknowledgement of Risks(Required)3. I understand and acknowledge that a) The Activities have foreseeable and unforeseeable inherent risks, hazards and dangers that no amount of care, caution or expertise can eliminate, including without limitation, the potential for serious bodily injury, permanent disability, paralysis and loss of life; b) The Organization may offer or promote online programming (such as webinars, remote conferences, workshops, and online training) which have different foreseeable and unforeseeable risks than in-person programming; c) The Organization has a difficult task to ensure safety and it is not infallible. The Organization may be unaware of my fitness or abilities, may misjudge weather or environmental conditions, may give incomplete warnings or instructions, and the equipment being used might malfunction; and COVID-19 d) The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization and COVID-19 is extremely contagious. The Organization has put in place preventative measures to reduce the spread of COVID-19; however, the Organization cannot guarantee that I will not become infected with COVID-19. Further, participating in the Activities could increase my risk of contracting COVID-19. 4. I am participating voluntarily in the Activities. In consideration of my participation, I hereby acknowledge that I am aware of the risks, dangers and hazards associated with or related to the Activities. The risks, dangers and hazards include, but are not limited to: a) Contracting COVID-19 or any other contagious disease; b) The sport of football; c) Privacy breaches, hacking, technology malfunction or damage while interacting with online training; d) Executing strenuous and demanding physical techniques; e) Dryland training including weights, running, bands, and massage; f) Vigorous physical exertion, strenuous cardiovascular workouts and rapid movements; g) Exerting and stretching various muscle groups; h) Physical contact with other participants; i) Failure to act safely or within my own ability or designated areas; j) Any risks inherent to the sport of football k) The failure to properly use any piece of equipment or from the mechanical failure of any piece of equipment; l) Serious injury to virtually all bones, joints, ligaments, muscles, tendons and other aspects of my body or to my general health and well-being; m) Abrasions, sprains, strains, fractures, or dislocations; n) Concussion or other head injuries, including but not limited to, closed head injury or blunt head trauma; o) Spinal cord injuries which may render me permanently paralyzed; p) Negligence of other persons, including other spectators or, participants, or employees; q) Travel to and from competitive events and associated non-competitive events which are an integral part of the Activities; and r) Negligence on the part of the Organization, including failure by the Organization to take reasonable steps to safeguard or protect me from the risks, dangers and hazards associated with my participation in the Activities. I agreeTerms(Required)5. In consideration of the Organization allowing me to participate in the Activities, I agree: a) That when I practice or train in my own space, I am responsible for my surroundings and the location and equipment that I select; b) That my mental and physical condition is appropriate to participate in the Activities and I assume all risks related to my mental and physical condition; c) To comply with the rules and regulations for participation in the Activities; d) To comply with the rules of the facility or equipment; e) That if I observe an unusual significant hazard or risk, I will remove myself from participation and bring my observations to a representative of the Organization immediately; f) The risks associated with the Activities are increased when I am impaired and I will not to participate if impaired in any way; g) That it is my sole responsibility to assess whether any Activities are too difficult for me. By commencing an Activity, I acknowledge and accept the suitability and conditions of the Activity; h) That COVID-19 is contagious in nature and I may be exposed to, or infected by, COVID-19 and such exposure may result in personal injury, illness, permanent disability, or death; and i) That I am responsible for my choice of safety or protective equipment and the secure fitting of that equipment. Release of Liability and Disclaimer 6. In consideration of the Organization allowing me to participate, I agree: a) That the sole responsibility for my safety remains with me; b) To ASSUME all risks arising out of, associated with or related to my participation; c) That I am not relying on any oral or written statements made by the Organization or its agents, whether in a brochure or advertisement or in individual conversations, to agree to participate in the Activities; d) To WAIVE any and all claims that I may have now or in the future against the Organization; e) To freely ACCEPT AND FULLY ASSUME all such risks and possibility of personal injury, death, property damage, expense and related loss, including loss of income, resulting from my participation in the Activities; f) To FOREVER RELEASE AND INDEMNIFY the Organization from any and all liability for any and all claims, demands, actions, damages (including direct, indirect, special and/or consequential), losses, actions, judgments, and costs (including legal fees) (collectively, the “Claims”) which I have or may have in the future, that might arise out of, result from, or relate to my participation in the Activities, even though such Claims may have been caused by any manner whatsoever, including but not limited to, the negligence, gross negligence, negligent rescue, omissions, carelessness, breach of contract and/or breach of any statutory duty of care of the Organization; g) To FOREVER RELEASE AND INDEMNIFY the Organization from any action related to my becoming exposed to or infected by COVID-19 as a result of, or from, any action, omission or negligence of myself or others, including but not limited to the Organization; h) That the Organization is not responsible or liable for any damage to my vehicle, property, or equipment that may occur as a result of the Activities; i) That negligence includes failure on the part of the Organization to take reasonable steps to safeguard or protect me from the risks, dangers and hazards associated with the Activities; I agreeAcknowledgement(Required)7. I acknowledge that I have read and understand this agreement, that I have executed this agreement voluntarily, and that this agreement is to be binding upon myself, my heirs, spouse, children, parents, guardians, next of kin, executors, administrators and legal or personal representatives. I further acknowledge by signing this agreement I have waived my right to maintain a lawsuit against the Organization on the basis of any claims from which I have released herein. I agree Δ
