Participation Form

Name of Surfer *

First Name

Last Name

Address (parent/guardian if under 18) *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Disclaimer (accepted by parent/guardian if under 18) *

By returning this completed form, I agree to taking part in the activities of the club. I understand that in the event of any injury or illness all reasonable steps will be taken to deal with that injury/illness appropriately. I agree that I will abide by the instructors professional judgement throughout the activity time and follow guidance and the advice given, which will be in the interest of my own safety and safety of other club members and instructors. I understand that NWSC and Quiksilver Surf School/ SUP Surf Co accept no liability for loss or injury sustained as a result of horseplay, or failure to comply with the instructors directions, requirements or instructions. By signing this form I am agreeing to abide by the instructors professional judgement, advice and instructions to protect my own safety and that of other club members. I understand the NWSC and Quiksilver Surf School/ SUP Surf Co do not accept responsibility for loss or damage of personal items either during activities or whilst items are left in the lockers or changing rooms. I understand that I will not be included in any club activities if I am under the influence of illegal drugs or alcohol. If payment has been received for a club session and I am refused participation due to my own inappropriate behavior, drug or alcohol use the payment will not be refunded. I understand that surfing is an extreme sport and although directly controlled by the instructors and all efforts are made to reduce risk to a minimum there is still a risk of injury or death. By signing this form I confirm that I can swim and will endeavor to have fun at all opportunities whilst abiding by the above statements

I agree

Photography Permission *

From time to time, NWSC take photographs and film footage for general publicity use. To do this, we need written consent. These photographs may be stored and could be used for a range of purposes, including publication and on the club’s website and also social media. They may be used to publicize events or activities involving the club. I give my permission to be photographed.

Yes

No

Corona Virus Disclaimer *

I do not display any signs or symptoms of the Corona Virus and have not in the past 2 weeks. I have no reason to think I may be contagious. If I develop any signs or symptoms of the Corona Virus within 2 weeks of any club session I will inform the club immediately , cease attendance at any club events and follow Government guidelines on self isolation.

Yes

Surfer Date of Birth *

MM

DD

YYYY

Emergency Contact Name *

First Name

Last Name