2011 'CN FUTURE LINKS' JUNIOR CLINICS ONLINE REGISTRATION
GARY BOS GOLF ACADEMY


GENDER

JUNIOR - GIVEN NAME
JUNIOR - LAST NAME
JUNIOR - DATE OF BIRTH
PARENT OR LEGAL GUARDIAN
EMAIL
PHONE - DAYTIME
PHONE - EVENING
EMERGENCY CONTACT #1
EMERGENCY CONTACT #2
EMERGENCY PHONE #1
EMERGENCY PHONE #2
ALLERGIES OR MEDICAL CONDITIONS
2011 CN FUTURE LINKS CLINIC PROGRAM
MEMBERSHIP AFFILIATION


COMMENTS OR SPECIAL REQUESTS
RELEASE, WAIVER & ASSUMPTION OF RISK AGREEMENT
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RELEASE, WAIVER AND ASSUMPTION OF RISK AGREEMENT BY A PARENT OR GUARDIAN
(if the Junior Golfer is under 18 years of age)

THIS RELEASE, WAIVER AND ASSUMPTION OF RISK AGREEMENT
by a parent or legal guardian applies to participation by the Junior Golfer in any aspect of the Junior Golfer Program.

By sumbitting the above registration form , I hereby acknowledge and agree to the following in consideration of (the "Junior Golfer") being permitted to participate in the activities of the Gary Bos Golf Academy ("GBGA"), Peninsula Lakes Golf Club Ltd. ("PLGCL"), Sparrow Lakes Golf CLub ("SLGC"), & Westport Golf & Practice Facility ("WG"):

1. Participation Liability Release:

I acknowledge that I have voluntarily chosen to enrol the Junior Golfer in training, activities, programs and events conducted at GBGA, PLGCL, SLGC & WP (collectively, the "Junior Golfer Program").

2. Acknowledgement of Risks:

GBGA, PLGCL, SLGC & WP strives to provide a safe environment for its Junior Golfer Program. However, it is important for all program participants and parents and legal guardians to understand that, even with safety measures, participation in the Junior Golfer Program involves unavoidable exposure to risk of injury. I hereby acknowledge and agree that some activities and some aspects of the Junior Golfer Program may expose the Junior Golfer to risks and hazards, including but not limited to:

(a) injuries suffered from any and all contact with golfing equipment, including but not limited to golf balls and golf clubs;
(b) injuries suffered from falling, running, walking or any other sport-related activity;
(c) overexertion;
(d) allergic reactions to any food or beverage served during the Junior Golfer Program; and
(e) allergic reactions to sunscreen applied to the Junior Golfer's skin during the Junior Golfer Program.

3. Assumption of Risk:

I understand that the Junior Golfer may be exposed to risks and hazards other than those described in section 2(a) to (e), and I freely and voluntarily assume any and all risks and hazards for the Junior Golfer.

4. No Increased Susceptibility to Risk:

I hereby represent that I have advised GBGA, PLGCL, SLGC & WP of any facts known to me which would make the Junior Golfer more susceptible to injury or risk of injury as a result of participating in the Junior Golfer Program than would be the average person of the same age. I have thoroughly explained to the Junior Golfer the risks associated with participating in the Junior Golfer Program using language appropriate for the age and intellectual capacity of the Junior Golfer.

5. Medical Release/Authorization:

I hereby give permission to GBGA, PLGC, SLGC & WP staff to transport the Junior Golfer to a doctor and/or hospital for treatment. I authorize all medical, surgical, diagnostic and hospital care procedures which may be performed or prescribed by a licensed physician or emergency service providers when deemed immediately necessary or advisable by the physician or emergency service providers to safeguard the Junior Golfer's health. I hereby waive my right of informed consent to such treatment.

6. Continuing Responsibility:

I understand that it is my responsibility to update any and all changes to the Junior Golfer's personal health information as provided on the Junior Golfer's registration form as I become aware of such changes.

7. Waiver of Claims:

Without limiting the generality of the foregoing, I hereby release GBGA, PLGCL, SLGC & WP, its members, officers, directors, employees, volunteers, independent contractors and any and all affiliated third parties, from all liability, claims, and causes of action of any kind whatsoever, in respect of all personal injuries, loss of life or property losses which the Junior Golfer may suffer arising out of or in connection with the Junior Golfer Program. I further waive all claims against GBGA, PLGCL, SLGC & WP, its members, officers, directors, employees, volunteers, independent contractors and any and all affiliated third parties, for any and all direct, incidental and consequential damages relating in any way to GBGA, PLGCL, SLGC & WP.

8. Own Insurance:

I understand that I am strongly advised to procure my own prudent levels of insurance for the Junior Golfer covering participation in the Junior Golfer Program. I understand and recognize that I must and will look solely to my own insurance, if any, for any loss occurring at, or relating to, the Junior Golfer Program. I understand and agree that GBGA, PLGCL, SLGC & WP has no obligation to procure insurance on my behalf.

9. Indemnification:

I understand and agree on behalf of the Junior Golfer and all other heirs, assigns, and legal and personal representative(s) (each, an "Affiliated Party"), that the Junior Golfer and any Affiliated Party are also subject to this Waiver. Understanding that damages may be caused to others by or related to the Junior Golfer's participation in the Junior Golfer Program, I agree to completely indemnify and hold harmless GBGA, PLGCL, SLGC & WP, its members, officers, directors, employees, volunteers and independent contractors, from any claim by any third party arising from or related to the Junior Golfer's participation in the Junior Golfer Program, plus all costs, except where such claim arises solely from the negligence of GBGA, PLGCL, SLGC & WP.

10. Severability:

If any provision of this Release, Waiver and Assumption of Risk Agreement shall be unlawful, void, or for any reason unenforceable, then that provision shall be deemed severable from this Release, Waiver and Assumption of Risk Agreement and shall not affect the validity and enforceability of any remaining provisions.

11. Duration:

This Release, Waiver and Assumption of Risk Agreement shall be effective for each and every activity and event conducted as part of or in connection with the Junior Golfer Program that is participated in by the Junior Golfer for one (1) year after the date of execution.

12. Full Comprehension and Consent:

I acknowledge and agree that I have carefully read all of the terms of this Release, Waiver and Assumption of Risk Agreement. I fully understand this Release, Waiver and Assumption of Risk Agreement, and I am freely and voluntarily executing same. I understand clearly that by signing this Release, Waiver and Assumption of Risk Agreement, I will forever be prevented from suing or otherwise claiming against GBGA, PLGCL, SLGC & WP, its members, officers, directors, employees, volunteers, independent contractors and any and all affiliated third parties with respect to any matter in connection with the Junior Golfer Program.

13. Opportunity to Question:

I have been provided with adequate opportunity to read and understand this Release, Waiver and Assumption of Risk Agreement prior to agreeing & acknowledging same. Any questions that I may have with respect to this Release, Waiver and Assumption of Risk Agreement have been answered in full and to my complete satisfaction.


VIOLATION OF RULES/DESTRUCTION OF PROPERTY

I understand and agree that, for the safety and comfort of everyone, GBGA, PLGCL, SLGC & WP is a non-smoking facility, and is in conformance with all applicable laws governing drug use, alcohol use by minors, environmental protection, health and safety. Rules established to protect the property, privacy and safety of GBGA, PLGCL, SLGC & WP, golfers and staff, will be enforced.

I further understand that willful violation of golf camp & golf clinic rules can lead to the participant's dismissal from the Junior Golfer Program. GBGA, PLGCL, SLGC & WP reserves the right to dismiss or remove the participant for misbehaviour at any time. I acknowledge that if the participant is dismissed or otherwise removed from the golf camp & golf clinic, I will be completely responsible for making arrangements for transportation, and that GBGA, PLGCL & SLGC shall make no refunds of any funds paid in association with the Junior Golfer Program.

I understand that willful destruction of property will be my responsibility on behalf of the participant. GBGA, PLGCL, SLGC & WP is not responsible for lost, damaged or stolen personal belongings.

PHOTOGRAPHS AND RECORDINGS

Pictures may be taken and recordings may be made during activities and events of the Junior Golfer Program. Please advise us if you are willing to have the participant's photograph used by GBGA, PLGCL, SLGC & WP for the promotion of the Junior Golfer Program.

I, on my behalf and on behalf of the participant, give permission to GBGA, PLGCL, SLGC & WP to photograph participant and to use in printed form or display form for the promotion of youth golfing. I, on my behalf and on behalf of the participant, assign and transfer to GBGA, PLGCL, SLGC & WP any and all rights, including copyright, which I may have or the participant may have in this material.

EXECUTION OF RELEASE, WAIVER AND ASSUMPTION OF RISK AGREEMENT

I understand that I am required to read, understand, and execute the attached Release, Waiver and Assumption of Risk Agreement. I understand that submission of the above online registration form constitutes acceptance of the terms & conditions herein.

Note

When only one legal parent/guardian submits a registration form, indicating consent, he/she does so in good faith and is presumed to be acting with the consent of the other legal parent/guardian.