NSMRCA Standard Race Registration Form

 

 

 

Date:

__________

Race Fee:

$_______

 

 

Name:

__________________________________________

Member: Full

  _______

 

 

Address:

__________________________________________

Member: Part

  _______

 

 

Postal Code:

__________Telephone:______

Age:

__________

 

Total Fee:

$_______

 

 

Email:

__________________________________________

 

Next Of Kin:

__________________________Telephone:__________

 

 

 

 

 

 

 

 

 

 

 

 

 

Date:

__________

Race Fee:

$_______

 

 

Name:

__________________________________________

Member: Full

  _______

 

 

Address:

__________________________________________

Member: Part

  _______

 

 

Postal Code:

__________Telephone:______

Age:

__________

 

Total Fee:

$_______

 

 

Email:

__________________________________________

 

Next Of Kin:

__________________________Telephone:__________

 

 

 

 

 

 

 

 

 

 

 

 

 

Canoe Model:

_______________

Race Class:

_______________

 

 

 

Canoe Number:

_______________

 

 

 

Start Time:

_______________

Finish Time:

_______________

 

 

 

Elapsed Time:

_______________

 

PLACE:

_______________

 

 

 

 

 

 

 

 

 

 

 

 

Standard Release Form

 

 

We do hereby remise, release and forever discharge the organizers of the ______________________________ Race of and from and all manner of actions, cause of actions, suits, proceedings, debts, dues, contracts, judgments, damages, claims and demands whatsoever in laws on equity, which against said organizers we ever had, now have or which our heirs, executors or administrators hereafter can, shall or may have, for or by any reason of our participation in the so called race to held on ________________ . We further acknowledge that no representations as to the conditions, nature or hazards of the canoe race course have been made to us by the organizers, and assume all risks and responsibilities for injury to ourselves and others and any property damage that may result from participation in said events.

Signature:___________________________ Signature:__________________________


Parental Consent

 

 

I, ______________________________individually as parent and guardian of the above named minor do hereby give my consent of his/her participation in said event, and further release the organizers from all claims, demands of charges on account of any and all injuries to persons or property that may result by virtue of said minors , participation in said event.

 

Parent's Signature:__________________________________________

 

THE RIGHT TO REJECT ANY ENTRY IS RESERVED.
APPLICATIONS FOR ALL ENTRANTS UNDER 18 YEARS OF AGE MUST BE CO-SIGNED BY PARENT.