9th Annual Paddle the Park

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Team name   First name   Last name   Email address   Date of birth DD 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31    MM 01 02 03 04 05 06 07 08 09 10 11 12       YYYY 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922    Gender -- Male Female   Phone #   Address   Emergency contact name   Emergency phone #   City   Zip code / Postal code   State / Province   Course Choose one 1st Heat: Competative/Timed SUP Race 2nd Heat Recreational SUP paddle 3rd Heat: Recreational Kayak paddle   Category Choose one Juniors 12 & Under Juniors 13-17 Adults 18 -39 Adults 40-49 Adults 50-59 Adults 60 & Over Choose one Juniors 12 & Under Juniors 13-17 Adults 18 -39 Adults 40-49 Adults 50-59 Adults 60 & Over Choose one Juniors 12 & Under Juniors 13-17 Adults 18 -39 Adults 40-49 Adults 50-59 Adults 60 & Over   Event entry fee increases after September 30, 2021 Event entry fee TBD

Event T-shirt size  * Choose one Youth Small Youth Large Adult Small Adult Med Adult Large Adult XL Adult XXL   List any allergies (or type "None")  *   Become a member of the Friends  * NoYes   30.00 USD Additional donation towards Friends' programs  * NoYes   USD Do you need to rent equipment? If yes, please visit our website www.donate.friendsvinp.org/paddlerental  * NoYes

Total -- Calculate

Please review the waiver provided by the event organizer and click the check box below to accept it. Print waiver Waiver of Liability By signing this form, I _____________________________ agree, warrant and covenant as follows: (name) 1. I understand that I am participating in an event that involves being in the water, offshore in the ocean. The conditions at the time of the event can involve waves and wind that make the Paddle the Park event challenging for some participants. I understand that participating in this event is potentially hazardous. I represent that I am medically, physically and psychologically able and properly trained for the event. 2. I am entering into this event voluntarily. In consideration of the acceptance of this entry, I assume full and complete responsibility for any injury or accident, which may occur while I am traveling to, from or between event venues, during the event itself, or while I am on the premises of the event. 3. I also am aware of and assume all risks associated with participating in this event, including but not limited to falls, contact with other participants, effects of weather, boat traffic, drowning and sea conditions. I am aware that there are risks of contracting COVID-19 while participating in this event and I agree to take all appropriate precautions for my protection and the protection of others as recommended by the event organizers, the CDC or the Virgin Islands Department of Health. 4. I, for myself and my heirs and executors, hereby waive, release and forever discharge the Friends of Virgin Islands National Park, its sponsors, promoters and each of their agents, representatives, successors and assigns, and all other persons associated with the event, from all liabilities, claims, actions, or damages that I may claim or have against any of them arising out of or in any way connected with my participation in this event. 5. I understand that this waiver includes a waiver of any claims, regardless of cause and whether caused by negligence, the action or inaction of any of the above parties, or otherwise. 6. I understand that the entry fee is non-refundable and non-transferable. I hereby grant full permission to any and all of the above parties to use my image in photographs, videotapes, motion pictures, website images, recordings or any other record of this event. I hereby agree to the above conditions in full, __________________________ _____________________ _______________ Name Signature Date I accept the terms of the waiver Name of parent or guardian who approves this activity Please enter your name here