PSL- Winter Challenge 2022

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Who are you registering? Choose one Yourself Team

Team name   First name   Last name   Email address   Age on event date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 Gender -- Male Female   Emergency contact name   Emergency phone #   City Zip code / Postal code State / Province Country Distance Choose one 5K Paddle 10K Paddle 10 mile Surfski/Oc   Category Choose one 60 + 14 Male Female Under 18 Inflatable Female Inflatable Male Male Under 18 Prone Male SUP 14 Male 18-49 SUP 14 Male 50+ SUP 60+ Female SUP Female 14 18-49 SUP Female 14 50+ SUP ONE CLASS FEMALE SUP ONE CLASS MALE Choose one Female Under 18 Inflatable Female Inflatable Male Male SUP Male Under 18 Prone Male SUP 14 Male 18-49 SUP 14 Male 50+ SUP 60+ Female SUP Female 14 18-49 SUP Female 14 50+ SUP ONE CLASS FEMALE SUP ONE CLASS MALE Choose one OC1 OC2 Coed Team OC2 Female Team OC2 Male Team OC6 Pedal Ski Surfski

Please review the waiver provided by the event organizer and click the check box below to accept it. Print waiver PARTICIPANT LIABILITY AND PUBLICITY RELEASE PLEASE READ THIS DOCUMENT CAREFULLY BEFORE SIGNING. THIS DOCUMENT HAS LEGAL CONSEQUENCES AND WILL AFFECT YOUR LEGAL RIGHTS. 1. I understand that stand up paddling has an inherent risk of injury and I am participating in this event entirely at my own risk. I assert that (a) I am in good health and in proper physical condition to safely participate in the event, and (b) I have no known or knowable physical or mental conditions that would affect my ability to safely participate, or that would result in my participation creating a risk of danger to myself or to others. 2. I acknowledge and agree that none of the Event Organizer, their respective parent companies, subsidiaries, or affiliates, nor their respective, officers, employees, agents or representatives (collectively, the “Released Parties”) will be responsible for any injury or death sustained by me or any other participant as a result of my participation in this event. In consideration of being permitted to participate in the event, and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, to the fullest extent permitted by law, I hereby forever waive, release, covenant not to sue, and discharge the Released Parties from, and agree to indemnify and hold the Released Parties harmless from and against, any and all claims resulting from or arising out of my participation in the event, including without limitation, claims of personal injury, including death, and claims resulting from damage to, or loss or theft of, property. 3. I understand that any and all photographs, motion pictures, recordings, and/or likenesses of me captured during the event by or on behalf of the Event Organizer, or their respective affiliated entities or contractors, become the sole property of the Event Organizer or as applicable. I hereby grant the right, permission and authority to Event Organizer to use, publish, broadcast or otherwise disseminate, in any and all media worldwide, my name and any such photographs, motion pictures, recordings, and/or likenesses for any legitimate purpose, including but not limited to promoting, advertising, and marketing activities. I further understand that Event Organizer have the full right to sell and/or profit from the commercial use of such photographs, motion pictures, recordings, and/or likenesses. 4. The terms of this Release shall be binding on me and my heirs, executors, administrators and any other legal or personal representatives. If I am a parent or legal guardian signing this form on behalf of a minor, I acknowledge and agree that all representations, consents, agreements and releases herein shall be regarded as made by me on behalf of the minor and shall be binding on me and the minor. I hereby certify that I have read and understand the foregoing and intend to be legally bound. I accept the terms of the waiver Name of parent or guardian who approves this activity