BEPC 2021 Race Series #8

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Team name   First name   Last name   Email address   Gender -- Male Female   Phone #   Emergency contact name   Emergency phone #   Category Choose one Canoe Kayak OC1 Other Prone SUP Surfski

I am a BEPC member NoYes

Please review the waiver provided by the event organizer and click the check box below to accept it. Print waiver I, for being allowed to participate in Ballard Elks Paddling Club events hosted by the Ballard Elks and the Ballard Elks Paddling Club, agree to indemnify and hold harmless the Ballard Elks Lodge #827 & the Ballard Elks Paddling Club, its officers, employees and members from any and all claims or injury to myself arising out of my participation in this event. (If the participant is a minor, a parent or guardian must sign, thereby providing permission for the named minor to participate in the named event). Furthermore, I allow the use of photographs or images arising out of my participation in this event. I accept the terms of the waiver Name of parent or guardian who approves this activity Please enter your name here