SRFSC WINTER CLASSIC Club Certification

2000 Santa Rosa's Winter Classic Synchronized Team Skating Competition
ASSUMPTION OF RISK AND WAIVER OF LIABILITY FORM
AND CERTIFICATE OF CLUB OFFICIAL


CERTIFICATE OF CLUB OFFICIAL

I hereby approve the entry of the registrant and certify that he or she:
1.  Is a member of the Club in good standing.
2.  To the best of my knowledge is eligible to enter the specified event(s).
3.  Is an amateur in accordance with the rules of the United States Figure Skating Association: and
4.  is following a standard and complete education pogram in full compliance with the requirements of the registrant's home state.

NAME OF CLUB OFFICIAL: (Please Type Or Print Legibly)  ________________________________________________________________________________  

CLUB OFFICER SIGNATURE  _________________________________________________________________________      DATED______________________  

TITLE OF OFFICE  ___________________________________________________________________          HOME CLUB OR CITY______________________  

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SKATERS UNDER AGE 18, ONE FORM REQUIRED FOR EACH SKATER

CONSENT OF PARENT OR LEGAL GUARDIAN (ASSUMPTION OF RISK AND WAIVER OF LIABILITY)
(For Skaters Under Age 18)


I am the parent of ___________________________________________________________________
I understand that my child/ward will be participating in the 2000 Santa Rosa's Winter Classic Synchronized Team Skating Competition at the Redwood Empire Ice Arena, 1667 West Steele Lane, Santa Rosa, California, 95403.
I understand that the proposed activity can be a dangerous sport, and that the Arena's officers, management, owners and employees and all members or staff of the United States Figure Skating Association and/or The Santa Rosa Figure Skating Club assume NO responsibility for accidents or injuries to participants or spectators, or loss of property, occurring before, during or after the activity.

I accept full responsibility for ensuring that my child/ward is adequately supervised and controlled while on The Redwood Empire Ice Arena property, and accept responsibility for accidents or injuries to myself, and my child/ward, and for property damage, arising as a result of said activity. I hereby waive all rights to assert or levy any and all claims, losses, liabilities, costs and/or liens against the corporations known as ìRedwood Empire Ice Arena, Inc.î, and/or ìRedwood Empire Ice Operations, Inc.î, and the organizations known as ìThe United States Figure Skating Associationî and /or ìThe Santa Rosa Figure Skating Clubî and these corporations' and organizations' officers, management, agents, officials and staff from and against any and all claims, losses, liabilities, costs and/or liens for accidents or injuries to my child/ward, or any other person, or property damage caused by or arising out of his/her participation in the above activity, and occurring before, during or after the activity.

If I am not able to personally supervise and control the activities of my child/ward while on the Redwood Empire Ice Arena property, I agree to provide all necessary medical consents, medical information and emergency numbers to persons of suitable age and discretion who have agreed to supervise and control my child/ward.
I have signed the foregoing form in my individual capacity, and on behalf of my child/ward, and his/her heirs, executors and/or administrators.

SIGNATURE___________________________________________________________DATED____________________________________

PRINT NAME__________________________________________________________CAPACITY__________________________________

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SKATERS AGE 18, AND OVER, PLEASE USE THIS FORM

ASSUMPTION OF RISK AND WAIVER OF LIABILITY
(For Adults, 18 Years And Over)


Ice skating can be a dangerous and injurious sport. All skaters and spectators assume their own risk of injury. The Arena's officers and management, owners and employees, The United States Figure Skating Association, the competition officials and members of The Santa Rosa Figure Skating Club assume NO responsibility for accidents or injuries to participants and spectators, or loss of property, occurring before, during, or after these competitive programs. Each participant is responsible for accidents or injuries to the participants and to others as a result of the participant's activities.

Skaters and skating parents must understand and accept the full risk and financial responsibility of participation in this competition and waiver all rights to assert or levy any and all claims, losses, liabilities, costs and/or liens against the corporations known as "Redwood Empire Ice Arena, Inc.", and/or "Redwood Empire Ice Operations, Inc.", and the organizations known as "The United States Figure Skating Association" and/or "The Santa Rosa Figure Skating Club". Furthermore, the skater must waive the rights of their heirs, executors and/or administrators of their estate to assert or levy any and all claims, losses, liabilities, costs and/or liens against the aforementioned corporations and organizations, officers, management, agents, officials and staff from and against any and all claims, losses, liabilities, costs and/or liens for accidents or injuries to themselves or any other person, or property caused by or arising out of their participation in this competition.

SIGNATURE_______________________________________________________________DATED________________________________

PRINT NAME________________________________________________________________________________________________

Go to Winter Classic Application RULES AND GENERAL INFORMATION.
Go to MAP TO ARENA AND LODGING.
Go to Winter Classic TEAM ENTRY FORM - submit (1) per team.
Go to Winter Classic TEAM SKATING ROSTER - submit (1) per team.
This is Winter Classic CERTIFICATE OF CLUB OFFICIAL AND WAIVER - submit (1) per skater.

Go to Winter Classic Main Page.

Go to Competitions Index
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