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INSTRUCTIONS FOR JOINING C.A.S.L. BY MAIL THESE FORMS MUST BE NOTARIZED IF YOU UNDER 18. ONE HARDCOPY MUST BE MAILED TO C.A.S.L. FOR MEMBERSHIP REGISTRATION WITH THE APPROPRIATE MEMBERSHIP FEES. THE PROCESSED FORM WILL BE SENT TO YOUR RETURN ADDRESS WITH YOUR MEMBERSHIP NUMBER. |
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PRINT THE FORMS AND INSTRUCTIONS ON YOUR COMPUTER SCREEN BY: A. SELECT the FILE function on your web BROWSER. B. CHOOSE the PRINT option and PRINT your forms. |
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| 2. | READ and COMPLETELY fill out all FOUR PARTS of the C.A.S.L. FORM & the CAMP WOODWARD WEST form. | |||||||||||||||
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| 3. | MEMBERS 18 & OVER: Make sure you sign and date the form | |||||||||||||||
| 4. | MEMBERS UNDER 18: This must be done before your first contest every year until your 18th birthday. Public Notaries are listed in the yellow pages of yuur telephone directory. | |||||||||||||||
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Mail the completed form and fees to the C.A.S.L. OFFICE. Please make check or money order payable to: UNITED SKATEBOARD FEDERATION |
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| 7. | C.A.S.L.'S MAILING ADDRESS IS: | |||||||||||||||
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| 8. | MORE INFORMATION: If you need more information on C.A.S.L. or any of our other programs, our office hours are Tuesday through Thursday, 1am to 4pm. | |||||||||||||||
PHONE: 909-883-6176 <> FAX: 909-883-8036
sanctioned by: THE UNITED SKATEBOARD FEDERATION, INC.
| Membership No: __________ |
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UNITED SKATEBOARD FEDERATION, INC., dba…C.A.S.L. |
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THIS FORM MUST BE NOTARIZED BY PARENT (S) OR LEGAL GUARDIAN (S) OF ALL PARTICIPANTS UNDER THE AGE OF 18. |
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PART ONE: ATHLETIC WAIVER & RELEASE OF LIABILITY IN CONSIDERATION OF BEING ALLOWED TO PARTICIPATE IN ANY WAY IN THE UNITED SKATEBOARD FEDERATION, dba "C.A.S.L.", ATHLETIC-SPORTS PROGRAM, AND ITS RELATED EVENTS AND ACTIVITIES, THE UNDERSIGNED: |
| 1. | AGREE, ACKNOWLEDGE AND FULLY UNDERSTAND THAT EACH PARTICIPANT WILL BE ENGAGING IN ACTIVITIES THAT INVOLVE RISK OF SERIOUS INJURY, INCLUDING PERMANENT DISABILITY, AND DEATH, AND SEVERE SOCIAL AND ECONOMIC LOSSES WHICH MIGHT RESULT NOT ONLY FROM THEIR OWN ACTIONS, INACTIONS, OR NEGLIGENCE, BUT THE ACTION, INACTION, OR NEGLIGENCE OF OTHERS, THE RULES OF PLAY, OR THE CONDITION OF THE PREMISES OR OF ANY EQUIPMENT USED. FURTHER, THAT THERE MAY BE OTHER RISKS NOT KNOWN TO US OR NOT REASONABLY FORESEEABLE AT THIS TIME. |
| 2. | ASSUME ALL THE FOREGOING RISK AND ACCEPT PERSONAL RESPONSIBILITY FOR THE DAMAGES FOLLOWING SUCH INJURY, PERMANENT DISABILITY, OR DEATH. |
| 3. | RELEASE, WAIVE, DISCHARGE, HOLD HARMLESS, AND COVENANT NOT TO SUE THE UNITED SKATEBOARD FEDERATION, dba "C.A.S.L.", ITS AFFILIATED CLUBS, THEIR RESPECTIVE ADMINISTRATORS, DIRECTORS, AGENTS, COACHES, AND OTHER EMPLOYEES OF THE ORGANIZATION, OTHER PARTICIPANTS, SPONSORING AGENCIES, SPONSORS, ADVERTISERS, AND, IF APPLICABLE, OWNERS AND LEASERS OF PREMISES USED TO CONDUCT THE EVENT, ALL OF WHICH ARE HEREINAFTER REFERRED TO AS "RELEASES", FROM ANY AND ALL LIABILITY TO EACH UNDERSIGNED, HI OR HER HEIRS AND NEXT OF KIN FOR ANY AND ALL CLAIMS, DEMANDS, LOSSES OR DAMAGES ON ACCOUNT OF INJURY, INCLUDING DEATH OR DAMAGE TO PROPERTY, CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE RELEASES OR OTHERWISE. |
| PART TWO: RELEASE OF VIDEO RIGHTS |
| 1. | IN CONSIDERATION FOR BEING PERMITTED TO COMPETE, OBSERVE, WORK FOR, OR FOR ANY PURPOSE PARTICIPATE IN ANY WAY IN ANY "C.A.S.L." CONTEST OR EVENT DURING 2008, THE UNDERSIGNED, FOR HIMSELF, HIS PERSONAL REPRESENTATIVES, HEIRS AND NEXT OF KIN UNDERSTANDS THAT ALL OR PORTIONS OF THE CONTEST(S) AND/OR EVENT(S) MAY BE VIDEOTAPED FOR FUTURE VIEWING AND THAT THE UNDERSIGNED MAY APPEAR, WITHOUT COMPENSATION, IN THE VIDEOTAPE. |
| 2. | THE UNDERSIGNED HEREBY RELEASES TO "C.A.S.L." ALL RIGHTS TO ALL VIDEO REPRODUCTIONS OF THE "C.A.S.L." CONTEST(S)/EVENT(S). |
| PART THREE: AUTHORIZATION TO TREAT A MINOR AND/OR RELEASE OF PATIENT'S RECORD |
| 1. | I, THE UNDERSIGNED, DO HEREBY AUTHORIZE ANY HOSPITAL, PHYSICIAN, OTHER PERSON WHO HAS ATTENDED ME OR EXAMINED ME TO FURNISH "C.A.S.L." OR ITS REPRESENTATIVES, ANY AND ALL INFORMATION WITH RESPECT TO ANY ILLNESS, INJURY, MEDICAL HISTORY, CONSULTATION, PRESCRIPTIONS, OR TREATMENT, AND COPY ALL HOSPITAL OR MEDICAL RECORDS. A PHOTO STATIC COPY OF THIS AUTHORIZATION SHALL BE CONSIDERED AS EFFECTIVE AND VALID AS THE ORIGINAL. |
| 2. | I / WE THE UNDERSIGNED PARENT(S) OR LEGAL GUARDIAN OF THE BELOW NAMED MINOR, DO AUTHORIZE AND CONSENT TO ANY XRAY EXAMINATION, LABORATORY PROCEDURE, ANEDTHETIC, MEDICAL, OR SURGICAL DIAGNOSIS AND TREATMENT WHICH IS DEEMED ADVISABLE BY GENERAL MEDICAL STAFF OR EMERGENCY ROOM UNDER THE PROVISIONS OF THE STATE OF CALIFORNIA, DEPARTMENT OF PUBLIC HEALTH. |
| 3. | I / WE UNDERSTAND THAT AN EFFORT SHALL BE MADE TO CONTACT ME/US PRIOR TO RENDERING TREATMENT TO THE PATIENT, BUT THAT ANY OF THE ABOVE TREATMENT WILL NOT BE WITHHELD IF I/WE CANNOT BE REACHED. |
| 4. | IT IS UNDERSTOOD THAT THE PERSON PRESENTING THIS AUTHORIZATION IS ACTING AS MY/OUR AGENT AND WILL NOT BE HELD LIABLE FOR TREATMENT(S) AND OTHER SERVICES RENDERED. |
| 5. | I / WE ACCEPT FULL FINANCIAL RESPONSIBILITY FOR ALL MEDICAL TREATMENT(S) AND SERVICES RENDERED TO MY/OUR MINOR CHILD. |
2008C.A.S.L.
PART FOUR: MEMBERSHIP DATA & BEHAVIOR CODE
NUMBER OF YEARS IN C.A.S.L.___________ MEMBERSHIP NUMBER_________|
2008 C.A.S.L. CLASSES & AGE GROUPS |
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MEMBER'S NAME__________________________________________________________________ AGE___________________ ADDRESS________________________________________________________________________________________________ (NUMBER & STREET NAME) (CITY) (STATE) (ZIP CODE) BIRTH DATE ____________________ SHIRT SIZE _________________ HOME PHONE _________________________________ EMERGENCY INFORMATION SPECIAL MEDICATION; ALLERGIES; MEDICAL RESTCTIONS_______________________________________________________ IN CASE OF EMERGENCY PLEASE NOTIFY: (1)______________________________________________HOME PHONE ________________ WORK PHONE _______________ (2)______________________________________________HOME PHONE ________________ WORK PHONE _______________ DOCTOR ________________________________________ OFFICE PHONE ___________________________________________ INSURANCE CARRIER______________________________________________________________________________________ |
| C.A.S.L. BEHAVIOR CODE |
| 1. | THIS CODE APPLIES TO ALL CONTESTANTS, COACHES, MANAGERS, SPONSOR REPRESENTATIVES, PARENTS AND FRIENDS. | ||||||||||
| 2. | IT WILL BE SIGNED BY SKATER AND SKATER'S PARENT(S)/LEGAL GUARDIAN, IF SKATER IS UNDER 18 YEARS OF AGE, NO EXCEPTIONS. | ||||||||||
| 3. | THE RULES: | ||||||||||
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| 4. | THE PENALTIES: | ||||||||||
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IGNORANCE OF THIS CODE IS NO EXCUSE TO BREAK IT!!!! |
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I/WE, HAVING READ THE ABOVE WAIVER AND RELEASE, UNDERSTAND THAT WE HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT. WE HAVE SIGNED THIS WAIVER AND RELEASE VOLUNTARILY. I/WE, SPEAK, READ, WRITE, AND UNDERSTAND ENGLISH AS OUR PRIMARY LANGUAGE. IF ENGLISH IS NOT OUR PRIMARY LANGUAGE, THIS INFORMATION HAS BEEN TRANSLATED INTO OUR PRIMARY LANGUAGE FOR US AND WE DO UNDERSTAND ITS CONTENTS. |
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MEMBER'S SIGNATURE:_______________________________________________________________DATE:____________________________
PARENT/GUARDIAN'S SIGNATURE:______________________________________________________DATE:___________________________ MY/OUR RELATIONSHIP TO THE ABOVE NAMED MINOR IS _______________________________________________________________ |
2008 C.A.S.L.
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LIABILITY WAIVER (Minor, under 18) BY SIGNING THIS DOCUMENT YOU WILL WAIVE CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE |
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Camper Name: ______________________________________________________________________________________________________
Address: ______________________________________________ City: _________________________ State: _________ Zip: ____________
Date of Birth: _________________________________ Age: ______________ Phone: (___________)_________________________________
I am aware that in addition to the usual dangers and risks inherent in the sports of Skateboarding, Inline Skating, Mountain Biking, Freestyle BMX, BMX Racing, Snowboard/Freeski, Cheerleading, Gymnastics, Trampoline, Tumbling and other Woodward West activities, certain additional dangers and risks are present when using Woodward Facilities, Woodward Skate/Bike Facilities, Gymnastics Equipment and Trampoline, including, but not limited to, the danger and risk of falling, jumping, landing, misdirected skateboards and bikes, performing tricks and colliding with other staff, campers, media personnel and spectators. By signing this waiver, I freely accept and fully assume responsibility for all such dangers and risks and the possibility of personal injury, death, property damage or loss resulting therefrom. In consideration of utilizing the Woodward West, LLC, Facilities, Woodward Skate/Bike/Mountain Bike Facilities, Gymnastics Equipment and Trampolines and for other good and valuable consideration, I hereby agree as follows:
1. TO WAIVE ANY AND ALL CLAIMS for personal injury including death, illness, and/or property damage that I may have against Woodward West, LLC, Sports Management Group, Inc., Sports Partners LP, their shareholders, partners, principals, directors, officers, sponsors, affiliates, agents, employees, contractors, representatives and any volunteers in any way associated with Woodward West, LLC, all of whom are hereinafter collectively referred to as “the Releasees.”
2. TO RELEASE THE RELEASEES FROM ANY AND ALL LIABILITY for any loss, damage, injury, death, medical or other expense that I may suffer or that any other party may suffer as a result of my use of Woodward Facilities, Woodward Skate/Bike Facilities, Gymnastic Equipment and Trampoline or in my participation in the sports of Skateboarding, Inline Skating, Mountain Biking, Freestyle BMX, BMX Racing, Snowboard/Freeski, Cheerleading, Gymnastics, Trampoline, Tumbling, and other Woodward West activities, due to any cause whatsoever.
3. TO HOLD HARMLESS AND INDEMNIFY THE RELEASEES from any and all liability for any property damage or personal injury to any third party, resulting from my use of Woodward Facilities, Woodward Skate/Bike Facilities, Gymnastic Equipment and Trampoline or by my participation in the sports of Skateboarding, Inline Skating, Mountain Biking, Freestyle BMX, BMX Racing, Snowboard/Freeski, Cheerleading, Gymnastics, Trampoline, Tumbling, and other Woodward West activities.
4. THIS RELEASE OF LIABILITY SHALL BE EFFECTIVE AND BINDING upon my heirs, next of kin, executors, administrators, successors, and assigns in the event of my personal injury including death, illness, and/or property damage.
5. I ADDITIONALLY AGREE not to take unreasonable risks while participating in Skateboarding, Inline Skating, Mountain Biking, Freestyle BMX, BMX Racing, Snowboard/Freeski, Cheerleading, Gymnastics, Trampoline, Tumbling, and other Woodward West activities, including but not limited to attempting skills or tricks that I am not qualified to perform safely or causing any other participants/spectators unreasonable risk of harm.
6. I ADDITIONALLY AGREE that I shall follow correct safety procedures when using the Woodward Facilities, Woodward
Skate/Bike/Mountain Bike Facilities, Gymnastics Equipment and Trampoline. I also expressly grant to the Camp, and any third party authorized by the Camp, the right to film, videotape, photograph, record my voice and make any reproductions of my physical likeness and voice, and the irrevocable right in perpetuity to use, display, and digitally enhance or alter in any manner, such likeness in any media now known or hereafter devised, including, but not limited to, the exhibition and/or online use, broadcast, theatrically or on television, cable or radio, any motion picture film, video tape, DVD, CD or any Internet service or program in which such likeness may be used or otherwise, or any published articles, catalogs, or websites in which such likeness may be printed, used or incorporated, and in the advertising, exploiting and publicizing of the Camp, Camp products, licensed products, and all affiliated relationships.
The venue and place of trail of any dispute that may arise out of or be related to this agreement or the services to be performed pursuant to this agreement, or otherwise, to which Woodward West or its agents or employees is a party shall be in the Metropolitan Division Court in Kern County in the State of California.
I HEREBY CERTIFY THAT I am covered by my own Medical Insurance, and that I have read and understand this Release of Liability prior to signing it, and I am aware that by signing this Release of Liability I am waiving certain legal rights which I or my heirs, next of kin, executors, administrators, successors, and assigns may have against the Releasees.
Woodward shall have the right to impose any additional conditions which, in the opinion of the Releasees, will further the intent and legal rights and waivers provided herein.
This Liability Waiver was made and executed in the State of California and shall be governed by, enforced in and construed in
accordance with the laws of the State of California.
I acknowledge that in executing this Waiver, I are not relying on any inducements, promises, or representations made by the Releasees.
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PARENT/LEGAL GUARDIAN SIGNATURE Print Name Here Date
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CAMPER SIGNATURE Print Name Here Date
BOTH SIGNATURES REQUIRED!
Rev. Date 11/05