EMERGENCY AUTHORIZATION:
I, the undersigned parent or legal guardian of the above minor, or the above participant of legal age hereby
authorize Avalanche Enterprises and its affiliates (“Raging Buffalo”) and/or the
above-identified Emergency Contact/Chaperone to act as my agents in the
capacity of activity supervisors and vehicle drivers, and to consent to
medical, surgical or dental examination and /or treatment.
DISCLAIMER, ASSUMPTION OF RISK AND WAIVER:
I, the undersigned parent or legal guardian of the above minor, for
myself and on behalf of the above minor, our heirs, assigns and next of
kin (“I”), acknowledge that participation in Raging Buffalo programs
(including photo-shoots, snowboard camps, snowboard trips, wakeboard camps, wakeboard trips, wake surf camps, wake surf trips and other surf, skate,
snow and similar events that Raging Buffalo may sponsor or in which Raging Buffalo athletes may compete) involves travel, participation in
inherently dangerous activities (often in adverse conditions), physical
contact and risk of severe, permanent physical injury including brain
damage, nerve and spinal cord injury, paralysis and death. For myself,
and on behalf of the above minor, our heirs, assigns and next of kin,
we willingly and voluntarily accept and assume all such risk.
In
consideration of accepting and permitting the voluntary participation
of the above-named participant in Raging Buffalo programs, I hereby
release, discharge and agree to hold harmless Raging Buffalo, its
employees, volunteers, officials, sponsors and other representatives
from any and all damages, claims, demands, costs, expenses and
compensation arising out of or in any way related to any injury,
physical or otherwise, or other damage that may result to said
participant in connection with such program.
ACKNOWLEDGEMENT AND CONSENT:
I acknowledge that Raging Buffalo may compile and use the name, likeness,
recorded voice, addresses, photographs, film and videos of the named
individual in advertising, marketing, product, packaging or other use,
without compensation and without restriction as to duration, geography,
media or frequency. I consent to such uses and hereby waive all rights
to compensation.
I HAVE READ THE
ABOVE EMERGENCY AUTHORIZATION, DISCLAIMER, ASSUMPTION OF RISK AND
WAIVER, AND ACKNOWLEDGEMENT AND CONSENT AGREEMENTS, FULLY UNDERSTAND
THE TERMS OF EACH, UNDERSTAND THAT I AND THE ABOVE PARTICIPANT HAVE
GIVEN UP SUBSTANTIAL RIGHTS BY MY SIGNING THIS FORM AND AGREEING TO
THESE TERMS, AND I SIGN THIS FORM AND AGREE TO THESE TERMS FREELY AND
VOLUNTARILY AND WITHOUT INDUCEMENT FOR MYSELF AND ON BEHALF OF THE
ABOVE PARTICIPANT.
Participant Signature: ______________________________________________ Date: _____________________
Parent Signature: _________________________________________________ Date: _____________________
(if participant is a minor under the age of 18)
