PURE LIGHT RACING WAIVER AND RELEASE OF LIABILITY

In consideration of being permitted to participate in the sport of canoe paddling with Pure Light
Racing, including related events and activities, the undersigned, hereinafter referred to as the
Participant:
1. Agrees that prior to participating, Participant will inspect the facilities and equipment to be
used, and if he/she believe anything is unsafe, will immediately advise a Pure Light Racing
authorized representative of such condition(s) and refuse to participate.
2. Acknowledges and fully understands 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 from only his/her own actions, inactions or
negligence, but the action, inaction or negligence of others, or the condition of the premises
or of any equipment used. Further, that there may be other risks not known to Pure Light
Racing or not reasonably foreseeable at this time.
3. Assumes all the foregoing risks and accept personal responsibility for the damages following
such injury, permanent disability or death.
4. Releases, waives, discharges and covenants not to sue Pure Light Racing, its afliated clubs,
their representative administrators, directors, agents, coaches, and other volunteers or
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 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 Releasee or otherwise.
The undersigned custodial parent or legal guardian acknowledges that he/she is also signing
this release on behalf of the minor participant, that he/she is waiving certain rights on behalf of
the minor participant that the minor participant otherwise may have and that the minor
participant shall be bound by all of the terms of this release. By signing this waiver and release
without a parent!s or guardian!s signature, the participant represents he/she is at least 18 years
of age, or, if signing as the parent or guardian of the participant, signer represents they are the
custodial parent or legal guardian of the minor participant.
I/WE HAVE READ THE ABOVE WAIVER AND RELEASE, UNDERSTAND THAT I/WE HAVE
GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, HAVE NOT CHANGED IT ORALLY, AND
SIGN IT VOLUNTARILY.

X
Participant!s Signature Participant!s Name (PLEASE PRINT CLEARLY) Date

For participants under the age of 18,

X
Parent/Legal Guardian Signature Parent/Legal Guardian Name Relationship Emergency Phone Date


PLR Waiver 01/14

PURE LIGHT RACING SAFETY PROTOCOL
To be completed by all paddlers:
After initial paddling session, all participants will be required to complete a
mandatory swim test. Please contact any Pure Light Racing board member to
make arrangements.
Please note: At the discretion of the board any paddler that has participated in an
ofcial Pure Light Racing event with water changes will be considered to have
met the swim requirement. Please state race and year competed.
Race: Year:
Authorized Use Only:

Paddler can SWIM 25m unaided Yes No (Releaser!s Initials)
Paddler can TREAD water for 10 Min. Yes No (Releaser!s Initials)
Paddler can ACCESS canoe independently Yes No (Releaser!s Initials)

Paddler swam 25m unaided, date completed:
Approved by:
Paddler treaded water 10 min continuously, date completed:
Approved by:

PLR Waiver 01/14
PURE LIGHT RACING MEDIA/PHOTO WAIVER

I hereby authorize and give my full consent to Pure Light Racing to copyright and/or publish any
and all photographs, digital recordings, videotapes and/or lm in which I appear may be used for
public view. I further agree that Pure Light Racing may transfer, use or cause to be used, these
digital recordings, photographs, videotapes, or lms for any exhibitions, public displays,
publications, commercials, art and advertising purposes, television programs, and internet
without limitations or reservations.
X
Participant!s Signature Participant!s Name (PLEASE PRINT CLEARLY) Date
FOR PARTICIPANTS UNDER THE AGE OF 18
X
Parent/Legal Guardian Signature Parent/Legal Guardian Name Relationship Emergency Phone Date

PLR Waiver 01/14