In consideration for being allowed to participate in any way in activities sponsored by or associated with the American Canoe Association, Inc. and/or Cascade Canoe Club of Salem, the undersigned:

1. Agree that the parent(s) and/or legal guardian(s) will instruct the minor participant that prior to participating, he or she should inspect the facilities and equipment to be used, and if the participant believes anything is unsafe, he or she should immediately advise his or her coach or supervisor of such condition(s) and refuse to participate.

2. 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 actions, inactions 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.

3. Assume all the foregoing risks and accept personal responsibility for the damages following such injury, permanent disability or death.

4. Release, waive, discharge and covenant not to sue American Canoe Association, Inc., its affiliated clubs including, but not limited to, Cascade Canoe Club of Salem, 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 “releasees”, from any and all liability to each of the undersigned, his 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 releasees or otherwise.

5. This waiver may not be modified in any way. If any part of this waiver os determined to be invalid by, all other parts of this waiver shall remain valid and enforceable.

I/WE HAVE READ THE ABOVE WAIVER AND RELEASE, UNDERSTAND THAT WE HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT VOLUNTARILY.

Signature of Participant:Date:
Printed Name of Participant:Date of Birth:
Signature of Parent or Guardian:Date:
Printed Name of Parent or Guardian:Relationship:
Address of Participant:
City: State:	Zip:
ACA#: Club Organization:	Cascade Canoe Club of Salem