Appendix B – Sample Forms/Waivers – Release of Liability 

PENTASPORT MINISTRIES PARTICIPANT’S ASSUMPTION OF RISKS, RELEASE OF LIABILITY, WAIVER OF CLAIMS & INDEMNIFICATION AGREEMENT (collectively, this “Agreement”)

PLEASE READ AND REVIEW CAREFULLY.

By reviewing and signing this Agreement, I for myself and any minor child (under the age of 19) assume any and all risks in participating, waive the right to sue, waive the right to claim compensation, release any and all liabilities and agree to fully indemnify – all in favor of PentaSport Ministries, any and all associated entities, successors, predecessors, directors, officers, employees, agents, sponsors, assigns, contractors, representatives, and volunteers (collectively “PentaSport Ministries”).

I know and understand that participating in athletic, fitness and related activities (collectively, the “Activities”) – such as PentaSport Ministries – involves many risks, dangers and hazards.

I certify and warrant that I (1) am over age 19 and of full capacity to enter into this Agreement, (2) am medically able, physically fit, mentally capable, (3) am properly prepared and sufficiently trained for participation; (4) have not been advised by a healthcare professional not to participate; (5) have no health-related reasons or other problems that preclude my participation.

OR

I certify and warrant that (1) I am the parent/guardian of the minor and of full capacity and lawful authority to enter into this Agreement on my own behalf and on the minor’s behalf, (2) the minor is medically able, physically fit, mentally capable, (3) the minor is properly prepared and sufficiently trained for participation; (4) neither I nor the minor have been advised by a healthcare professional that the minor should not participate; (5) there are no health-related reasons or other problems that preclude the minor’s participation.

I alone am responsible for my own safety and well-being. Applications for the participation of minors in PentaSport Ministries shall be made and accepted only on behalf of a parent/guardian. That parent/guardian is solely responsible at all times for the minor’s safety and well-being.

I, for myself and any minor, FREELY, WILLINGLY, AND VOLUNTARILY ASSUME ANY AND ALL risks, dangers, hazards, loss to person or of property, damage to person or property, expense, injury, disability or death that may result from my participation or the minor’s participation in PentaSport Ministries — including but not limited to traveling to league practices; games; social events; warm-ups; stretching; walking; running; catching; throwing; checking; defending; slips; trips; falls; over-exertion; contact or collision with other participants or objects; presence of spectators or bystanders or other persons; blind spots; reduced visibility; equipment whether defective or not; property including facilities whether defective or not; the outdoors; terrain; vehicular traffic; temperature effects; weather; acts, omissions, breach of any duty of care, negligence, carelessness or fault of PentaSport Ministries; failure of PentaSport Ministries to take reasonable or any steps to safeguard or protect me or the minor from risks, dangers and hazards.

I understand participating in the Activities could result in my infection with the COVID-19 or such other communicable disease or contagion, which could involve flu-like symptoms, respiratory problems, organ failure, permanent disability, or death. I agree that I will not participate in any of the Activities, if (1) to the best of my knowledge and awareness, I am experiencing, or have experienced in the prior 14 days, flu-like symptoms or symptoms of any transmissible viral or bacterial infection or disease; or (2) to the best of my knowledge and awareness, I have been in contact in the prior 14 days with any person diagnosed with the COVID-19 virus. I will comply with all rules and regulations of PentaSport Ministries, Dominion of Canada, British Columbia and Public Health concerning matters of health and safety specifically as they relate to COVID-19 or such other communicable disease or contagion. I will not participate in any Activities if I have been advised by the BC Centre for Disease Control, any government agency, or my doctor to self-isolate due to possible exposure to COVID-19.

I understand that PentaSport Ministries is a not-for-profit sporting organization. In consideration of PentaSport Ministries agreeing to and permitting my participation or the minor’s participation in PentaSport Ministries, and for all other good and valuable consideration, the receipt and sufficiency of which is acknowledged, I, for myself, any minor and anyone entitled to act on my behalf — including but not limited to heirs, assigns, executors, administrators, next-of-kin and successors — WAIVE, FOREVER RELEASE, FULLY DISCHARGE AND PROMISE NOT TO SUE PentaSport Ministries from all present and future claims and liabilities for any loss to person or of property, damage to person or property, expense, injury, disability or death, of any kind known or unknown, arising out of my participation or the minor’s participation, due to any cause whatsoever, including but not limited to acts, omissions, breach of duty of care, negligence, carelessness or fault of PentaSport Ministries; or failure of PentaSport Ministries to take reasonable or any steps to safeguard or protect me or the minor from risks, dangers and hazards.

I, for myself and anyone entitled to act on my behalf — including but not limited to heirs, assigns, executors, administrators, next-of-kin and successors — consent and agree to FULLY INDEMNIFY AND HOLD HARMLESS PentaSport Ministries relating to any and all liabilities, claims, damages, costs, expenses, legal fees, arising from my participation, however caused, including but not limited to acts, omissions, breach of duty of care, negligence, carelessness or fault of PentaSport Ministries; or failure of PentaSport Ministries to take reasonable or any steps to safeguard or protect me from risks, dangers and hazards.

OR

As the parent/guardian, I, for myself, the minor and anyone else entitled to act on the minor’s behalf — including but not limited to heirs, assigns, executors, administrators, next-of-kin and successors — consent and agree to FULLY INDEMNIFY AND HOLD HARMLESS PentaSport Ministries relating to any and all liabilities, claims, damages, costs, expenses, legal fees, arising from the minor’s participation, however caused, including but not limited to acts, omissions, breach of duty of care, negligence, carelessness or fault of PentaSport Ministries; or failure of PentaSport Ministries to take reasonable or any steps to safeguard or protect the minor from risks, dangers and hazards.

I, for myself and any minor, consent to receive medical treatment which may be deemed advisable as per Dominion of Canada, British Columbia and Public Health concerning matters of health and safety specifically as they relate to COVID-19 or such other communicable disease or contagion in the event of an accident or incident, during my participation or the minor’s participation.

I understand that while participating, I and any minor may be recorded, photographed or filmed. I consent and authorize PentaSport Ministries to use any photographs, video, film, motion pictures, or any other record of my participation or the minor’s participation, without remuneration or other credit to me and any minor.

In entering into this Agreement, I, for myself and any minor, am not relying on any oral or written representations or statements respecting the safety of participating in PentaSport Ministries, other than what is expressly set out in this Agreement.

I, for myself and any minor, consent to be bound by all provisions of this Agreement.