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Release Form

If you or your child is sailing with SEA we need a release form completed. You can either download, print out and return a paper form, or you can complete the form here online.

SEA Release Form

ASSUMPTION OF RISK, RELEASE, HOLD HARMLESS AGREEMENT

Please read this Agreement and initial each and every provision in the space provided to indicate that you have read and fully understand it. Then sign and date this form. If you have any questions about this agreement, ensure to ask these questions before signing this Agreement.

NAME OF PARTICIPANT

Name of youth or adult participant. If you are filling this out for your child, this is your child's name not yours.

CONSENT TO PARTICIPATE

I am voluntarily participating in a Sailing Education Adventures activity (hereinafter collectively referred to as “SEA”) , including but not limited to classes, events, work days, boat rental and any other SEA activity in a boat, on a dock or on shore. I understand that there are certain risks associated with boating, and that serious accidents may occur during boating. I understand that participants in boating occasionally sustain serious or mortal personal injuries and/or property damage. I am fully informed to my satisfaction about Sailing Education Adventures’ activities, and the risks inherent in that program. The risks of injury associated with boating have been answered to my satisfaction. I knowingly and willingly choose to participate in a SEA’s activity at this time.

ASSUMPTION OF RISK

As stated above, I am fully aware that participating in any of SEA's activities may involve risks of physical injury and/or property damage. I know and understand the scope, nature and extent of the risks involved in this activity. I voluntarily and freely choose to assume any and all risks and dangers.

RELEASE OF SEA AND EXEMPTION FROM LIABILITY

I hereby fully and forever discharge and release SEA, its officers, directors, employees, agents, representatives, volunteers, staff, students, members, successors or assigns SEA from any and all liability, claims, demands, actions and causes of action whatsoever arising out of any damages, both in law and equity, in any way resulting from personal, physical, emotional or property injuries, distress or death sustained during SEA’s activities or programs. Exemption from liability by this provision includes any and all loss, damage or injury resulting from intentional conduct, omission and negligence, gross or otherwise, by SEA or from any other cause or causes.

PROMISE NOT TO SUE

As stated above, I agree not to institute, initiate, or assist the prosecution of any suit, claim or action at law or equity, otherwise, against SEA or its students for damages which I or my heirs, executors, administrators or assigns hereafter may have arising from my participation in any SEA activities.

INDEMNITY AGREEMENT

I agree to indemnify and hold harmless SEA from any and all losses, claims, actions or proceeding of any kind which may be directed against or be initiated by me and/or any other person or organization on my behalf. This includes reimbursement of all legal costs and reasonable counsel fees incurred by SEA or other indemnified parties as set forth in this Agreement for the defense of any such actions which may arise directly/indirectly from my participation in SEA programs.

LIFEJACKETS / PFDs

I agree to wear and ensure any crew wear USCG approved life jacket aboard vessel at all times.

ALCOHOL / ILLEGAL SUBSTANCES

I shall not board or operate any SEA vessel while intoxicated or under the influence of a controlled illegal substance.

UNDERSTANDING

I understand that this Agreement shall be construed and governed by the laws of the State of California, and that it cannot be modified unless in writing and signed by both parties. I hereby expressly recognize that this Agreement is a contract and that I have released any and all claims against SEA as defined above and any other indemnified parties which might result from my participation in any SEA class, program or activity, including any claims caused by the intentional or negligent acts of SEA and/or the indemnified parties. I HAVE CAREFULLY READ THIS AGREEMENT AND ASKED ANY QUESTIONS I HAD, ALL OF WHICH WERE ANSWERED TO MY SATISFACTION. I UNDERSTAND THE CONTENTS OF THIS AGREEMENT. I CERTIFY THAT I AM EIGHTEEN YEARS OF AGE OR OLDER, AND THAT I SIGN THIS AGREEMENT OF MY OWN FREE WILL.

MEDICAL INFORMATION

Medical insurer & policy #

Physician name & phone number

Blood type

Add if known

Date of last tetanus

month and year if known

Swimming ability

Medical Conditions

Do you have any medical condition we should be aware of?

Medications

Are you on any medication? If so, please list all medications

Emergency Contact(s)

Name, Phone Number and relationship

Note

Program organizers reserve the right to reasonably decide whether or not they will accept students or participants with certain medical, physical, psychological or behavioral problems which are discovered or disclosed either here or verbally. However, SEA makes no medical judgments about any particular risk to a particular participant and, by accepting this agreement, does not invalidate the participants’ waiver, consent or release .

SIGNATURE

By signing this form I certify that all statements in this form are true, complete and correct. My signature on this form authorizes SEA program organizers to sanction emergency medical treatment if my emergency contact(s) cannot be reached.

Signatory name

Name of person signing

First Name

Last Name

Phone

(###)

###

####

Signature

By writing your name in this field and submitting this form you are consenting to this being treated as an electronic signature.

YOUTH INFORMATION

Signed on behalf of

Year of birth of youth participant

PHOTO RELEASE CONFIRMATION

SEA occasionally uses photos of participants/members/campers for promotion purposes, and to give to the CA Division of Boating and Waterways in support of our programs. We will never use names. Because isolating individuals from group images is a nearly impossible task for our small staff, group images may be used as described above, but we can offer you the option to allow or limit the use of individual images of the participant (you or your child).

Photo release choice

Please indicate your choice for use of photos. We strongly encourage you to allow SEA to use participant's image (yours or your childs's) as described above. Thank you.

I am OK with individual images of participant being used.

I am NOT OK with individual images being used.

Signature

Please sign to confirm your photo release choice.