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Sight Night 2020 Virtual Run and Walk
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Online Membership Form for Under 18
Online Membership Form for Under 18
NOTE that the ASRAB membership is annual, and is valid January 1 – December 31 each year. Members must re-apply annually.
Individual - $15
Family - $30
Volunteer - no fee
Date of Birth: Month
Date of Birth: Day
Date of Birth: Year
Medical Condition / Allergies
Are you visually impaired?
If Visually Impaired - Condition?
Emergency Contacts (Please list 2 if possible)
Contact 1 Name
Contact 1 Relationship
Contact 1 emergency phone number
Contact 1 other phone
Contact 2 Name
Contact 2 Relationship
Contact 2 emergency phone number
Contact 2 other phone
Involvement with ASRAB
Please check if you are an athlete.
Please list sports
Please check if you are a volunteer.
Please list events
Please check if you are a coach.
Please list level / sports
Consent and Agreement of Terms
CONSENT FOR USE OF PERSONAL INFORMATION AND PHOTO RELEASE
2. Furthermore, I grant permission to ASRAB to photograph and/or record the Member’s image and/or voice on still or motion picture film and/or audio tape, and to use this material to promote ASRAB through social media and traditional media such as newsletters, websites, television, film, radio, print and/or display form. I understand that I waive any claim to remuneration for use of audio/visual materials used for these purposes.
3. I understand that I may withdraw such consent at any time by contacting ASRAB’s Privacy Officer. The Privacy Officer will advise the implications of such withdrawal. This consent is obtained in accordance with the Personal Information Protection and Electronic Documents Act and the Canadian Anti-Spam Legislation.
*ASRAB does not sell or distribute your personal information to any other third party not listed herein.*
By checking here, the Parties are consenting to the use of their electronic signatures in lieu of an original signature on paper and agree to the terms described in paragraphs 1 - 3.
Electronic Signature Consent
4. I give permission to the ASRAB to make decisions concerning the Member’s emergency medical care and treatment, and where necessary to authorize such care and treatment.
5. I hereby give my permission to the licensed physician, dentist, athletic therapist, nurse or other medical professional whose services might be required to provide emergency medical care and treatment to the Member.
By checking here, the Parties are consenting to the use of their electronic signatures in lieu of an original signature on paper and agree to the terms described in paragraphs 4 - 5.
Electronic Signature Consent
ACCEPTANCE OF TERMS AND CONDITIONS
In consideration of the acceptance of the Member’s membership in the ASRAB, I agree that the Member will:
6. Abide by the policies, rules and regulations of the ASRAB.
7. Sign a Release of Liability, Waiver of Claims and Indemnity Agreement (if the Member is 18 years old or older) or have the Member’s parent or guardian sign an Informed Consent and Assumption of Risk Agreement (if the Member is 17 years old or younger).
8. I have read, I understand and I accept the terms and conditions stated herein and I acknowledge that this agreement shall be effective and binding.
By checking here, the Parties are consenting to the use of their electronic signatures in lieu of an original signature on paper and agree to the terms described in paragraphs 6-8.
Electronic Signature Consent
INFORMED CONSENT AND ASSUMPTION OF RISK AGREEMENT (FOR PARTICIPANTS 17 YEARS OLD AND YOUNGER)
WARNING! By signing this document you will assume certain risks and responsibilities
1. This is a binding legal agreement. Clarify any questions or concerns before signing. Prior to participating, an individual who is younger than 18 years old and who wants to participate in the activities, programs, classes and services provided by, and/or in the events sponsored or organized by the Alberta Sports and Recreation Association for the Blind which may include but is not limited to: competitions, tournaments, practices, training, personal or strength training, dry land training, training using machines or weights, nutritional and dietary programs, orientational or instructional sessions or lessons, and aerobic and anaerobic conditioning programs (collectively the “Activities”) must have their legal parent/guardian (“the Parties”) acknowledge and agree to the terms outlined in this agreement
2. The undersigned acknowledges and agrees that they are a parent/guardian of the Participant and have full legal responsibility for the decisions of the Participant.
3. The Alberta Sports and Recreation Association for the Blind (ASRAB) and its directors, officers, members, employees, coaches, volunteers, officials, trainers, instructors, agents, 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 by the risks, dangers and hazards associated with the Activities.
Description and Acknowledgement of Risks
4. The Parties 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 the Participant’s fitness or abilities, may give incomplete warnings or instructions, may misjudge weather or environmental conditions, and the equipment being used might malfunction
The COVID-19 disease 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 the Participant will not become infected with COVID-19. Further, participating in the Activities could increase the Participant’s risk of contracting COVID-19
5. The Participant is participating voluntarily in the Activities. In consideration of that participation, the Parties hereby acknowledge that they are aware of the risks, dangers and hazards and may be exposed to such risks, dangers and hazards. The Parties understand that the Organization may fail to safeguard or protect the Participant from the risks, dangers and hazards of the Activities, some of which are listed below. The risks, dangers and hazards include, but are not limited to:
a) Health: executing strenuous and demanding physical techniques; physical exertion; overexertion; stretching; dehydration; fatigue; cardiovascular workouts; rapid movements and stops; lack of fitness or conditioning; traumatic injury; sprains and fractures, spinal cord injuries, bacterial infections; rashes; and the transmission of communicable diseases, including viruses of all kinds, COVID-19, bacteria, parasites or other organisms or any mutation thereof
b) Premises: defective, dangerous or unsafe condition of the facilities; falls; collisions with objects, walls, equipment or persons; dangerous, unsafe, or irregular conditions on surfaces; extreme weather conditions; and travel to and from the premises
c) Use of equipment: mechanical failure of the equipment; negligent design or manufacture of the equipment; the provision of or the failure by the Organization to provide any warnings, directions, instructions or guidance as to the use of the equipment; failure to wear safety or protective equipment; and failure to use or operate equipment within the Participant’s own ability
d) Contact: contact with participants, equipment, vehicles, or other persons; and other contact that may lead to serious bodily injury, including but not limited to concussions and/or other brain injury or serious spinal injury
e) Advice: negligent advice regarding the Activities
f) Ability: failing to act safely or within the Participant’s own ability or within designated areas
g) Cyber: privacy breaches; hacking; and technology malfunction or damage
h) Conduct: the Participant’s conduct and conduct of other persons including any physical altercation between participants
i) Travel: travel to and from the Activities
6. In consideration of the Organization allowing the Participant to participate in the Activities, the Parties agree:
a) That when the Participant practices or trains in their own space, the Parties are responsible for the Participant’s surroundings and the location and equipment that is selected for the Participant
b) That the Participant’s mental and physical condition is appropriate to participate in the Activities and the Parties assume all risks related to the Participant’s 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 the Participant observes an unusual significant hazard or risk, the Participant will remove themselves from participation and bring their observations to a representative of the Organization immediately
f) The risks associated with the Activities are increased when the Participant is impaired and the Participant will not participate if impaired in any way;
g) That it is their sole responsibility to assess whether any Activities are too difficult for the Participant. By the Participant commencing an Activity, they acknowledge and accept the suitability and conditions of the Activity
h) That they are responsible for the choice of the Participant’s safety or protective equipment and the secure fitting of that equipment
That COVID-19 is contagious in nature and the Participant may be exposed to, or infected by, COVID-19 and such exposure may result in personal injury, illness, permanent disability, or death
7. In consideration of the Organization allowing the Participant to participate, the Parties agree:
a) That the Parties are not relying on any oral or written statements made by the Organization or their agents, whether in brochure or advertisement or in individual conversations, to agree to participate in the Activities
b) That the Organization is not responsible or liable for any damage to the Participant’s vehicle, property, or equipment that may occur as a result of the Activities
c) That this Agreement is intended to be as broad and inclusive as is permitted by law of the Province of Alberta and if any portion thereof is held invalid, the balance shall, notwithstanding, continue in full legal force and effect
8. The Parties agree that in the event that they file a lawsuit against the Organization, they agree to do so solely in the Province of Alberta and they further agree that the substantive law of the Province of Alberta will apply without regard to conflict of law rules.
9. The Parties acknowledge that they have read this agreement and understand it, that they have executed this agreement voluntarily, and that this Agreement is to be binding upon themselves, their heirs, executors, administrators and representatives.
By typing in your name as participant below, your name as your parent/guardian below and clicking the “We Agree” icon, the Parties agree to be bound by this Legal Agreement.
Printed Name of Parent or Guardian
Printed Name of Participant
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