Surf School Registration Page

Parent/Guardian Name (First and Last Name)

Parent/Guardian Emergency Telephone

Parent/Guardian Email

Student Name (First and Last Name)

Select the days you would like each student to attend. The costs is $100 per day. You are welcome to attend all sessions, but each day will generally have the same curriculum. Your reservation is not confirmed until payment is received. See payment instructions below.

 June 26, 2009  July 17, 2009

Student Age (Years)

Student Height (Inches)

Student Weight (Pounds)

Additional Comments

RELEASE AGREEMENT

Please read the following and click "I ACCEPT" box at the end of this email if you agree.

THE COMPANY AND EACH PARTICIPANT HEREBY AGREE AS FOLLOWS:

1. Services. The Company will provide Services to one or more Participants. I will comply with all of the Company’s rules and recommendations related to Services.

2. Assumption of Risk. Engaging in the Activities in the ocean present inherent risks from many obvious and non-obvious hazards including but not limited to ocean currents, swells, rip currents, and waves, underwater objects, reefs, rocks, piers and pilings, other surfers, swimmers and beachgoers, boats and other water craft, and sharks, jellyfish, and other marine life and organisms. THE ACTIVTIES ARE DANGEROUS SPORTS, AND THE RISKS OF HARM CANNOT BE ELIMINATED. I VOLUNTARILY ASSUME ALL RISKS RELATED TO THE ACTIVITES AND SERVICES PROVIDED BY ANY RELEASED PARTY, including without limit risks of death, bodily injury, loss, property damage, falls, collisions with stationary objects, the unavailability of emergency medical care and the negligent acts and omissions of any person.

3. Release from Liability; Indemnification; Agreement Not to Sue. To the maximum extent permitted by applicable law, I HEREBY:

a. RELEASE AND DISCHARGE the Company and each of its owners, officers, employees, representatives, instructors, contractors, suppliers, and agents (all of whom are called individually a “Released Party” and collectively the “Released Parties”) from each and every claim, injury, loss, damage, cost or expense now existing or hereafter arising from any breach of duty, including for negligence, owed by any Released Party to any Participant related to or arising from (i) any Services, this Agreement, or any other service provided by any Released Party and/or (ii) any Activity in which any Participant engages in connection with this Agreement (all such claims, injuries, losses, damages, costs and expenses being called the “Released Claims”), whether involving death, bodily injury, property damage, consequential damages or otherwise.

b. INDEMNIFY AND HOLD EACH RELEASED PARTY COMPLETELY HARMLESS from any liability arising in respect of any Released Claim and from all defense costs including without limit attorneys fees in connection with defending any Released Claim; and

c. AGREE NOT TO SUE any Released Party on account of or in connection with any Released Claim.

4. Rights to Photographs and Films. I authorize the Company to take and use the name, voice, photographs, videotapes, audiotapes and other visual and audio recordings of each Participant, without compensation to any Participant. I agree that all such recordings may be used, and licensed to others, in promotional literature or publicity for the Company or any of its owners in any medium, together with any sound effects selected by the Company. I waive any rights of publicity in connection therewith.

5. Health Matters. I am physically and mentally fit, in good health, a competent swimmer and do not have or suffer from any physical or mental disease, illness or condition which might lead to a dangerous situation as to me or others during any surfing or related activities. If I have a health condition of which I may be unaware, I choose to participate in the Activities with the Released Parties and waive all responsibilities of any Released Party for any consequences arising from my activities. If I feel ill or unwell or have any physical or mental complaints or sustain any injury, I will immediately notify the Released Party who is providing the Services.

6. Authorization for Health Services. I authorize each Released Party to perform first aid for me and each other Participant and obtain medical assistance whenever the Released Party deems appropriate, and I authorize any physician, dentist, nurse, hospital, ambulance or other health-care professional who responds to any request by any Released Party to order and perform such health-care services as such person or entity deems necessary or appropriate for me or my child. All fees, costs and other expenses of such services, including without limit ambulance, hospital, laboratory and doctor fees and charges, shall be my sole responsibility.

7. Other Terms. This Agreement legally binds me, my minor children and my heirs, executors and administrators and is for the benefit of each Released Party and its successors and assigns, heirs, executors and administrators. No term of this Agreement may be amended, waived or otherwise altered except in writing signed by each Participant and the Company. All information about each Participant in this Agreement is correct. This Agreement is intended to be as broad and inclusive in protected Released Parties as permitted by applicable law. If any term is held invalid, all other terms shall remain in full force and effect. This Agreement contains my entire agreement with the Released Parties with respect to the subject matter of this Agreement. I am not relying on any representation or statement or inducement not contained in this Agreement. THIS AGREEMENT SHALL BE GOVERNED BY THE LAWS OF THE STATE OF FLORIDA WITHOUT REGARD TO THE RULES ON CHOICE OF LAW. ALL DISPUTES RELATED TO THIS AGREEMENT SHALL HAVE EXCLUSIVE VENUE IN THE STATE AND FEDERAL COURTS FOR THE STATE OF FLORIDA.

I am at least 18 years of age (or am a parent or adult legal guardian of each Participant who is not 18 years of age) and have duly signed this Agreement for myself and each such Participant, and each reference in this Agreement to “I” includes me and each minor Participant who is my child or for whom I am signing as guardian.

I HAVE READ AND UNDERSTAND THIS RELEASE AGREEMENT BY WHICH I WAIVE LEGAL RIGHTS, ASSUME RISKS AND INDEMNIFY AGAINST LIABILITY FOR MYSELF AND EACH NAMED MINOR. I SIGN THIS AGREEMENT OF MY OWN FREE WILL AND AGREE TO BE LEGALLY BOUND BY IT.

I ACCEPT (Check the box to accept the agreement and then click SEND below to complete your registration.

A copy of this email will be sent to the email address you specified above.

PAYMENT INSTRUCTIONS.

After you submit your registration(s) for all children you would like to register, you can

(1) PAY ONLINE BY CREDIT CARD (CLICK HERE)

or

(2) Pay by cash or check at the event location. We will contact you to confirm your registration by email.

THANKS! WE WILL SEND OUT ADDITIONAL INFORMATION PRIOR TO THE EVENT DATE.