School & Coach Information Form

Your Role*

School*

Your Name

Phone

Email

School District

Team Practice Site/City

Day of the Week

Code of Ethics

Release, Hold Harmless/Indemnification
In applying to participate in WSA’s Scholastic Surf Series (SSS) surfing program and in exchange for the SSS’s acceptance of my membership form, I voluntarily agree to assume all risks incident to the sport of surfing and related activities in connection with the contests and surf team/club activities. I fully understand and comprehend the dangers of surfing. With full knowledge, comprehension and understanding of these dangers, I voluntarily accept and assume all risks involved in the activities in connection with contests and all surf team/club activities. I intend to be legally bound, hereby, for myself, my heirs, executors and administrators, hold harmless and release and forever discharge the Surf Club/Team, Scholastic Surf Series, Western Surfing Association, Surfing America, the State of California, State Beaches, Counties of Los Angeles, Orange, San Diego, San Luis Obispo, Santa Barbara, Ventura, the Cities of Del Mar, Encinitas, Huntington Beach, Los Angeles, Morro Bay, Oceanside, Pismo Beach, San Clemente, San Diego, Santa Monica and any other city where the above described events take place, the Oceanside Small Craft Harbor District, the Regents of the University of California, its officers, employees and agents, the city of San Clemente Redevelopment Agency, the participating schools and school districts, and any agent or official connected with the Surf Club/Team, and all sponsors and sponsoring agencies and their members, agents employees, volunteers and any officials connected with this competition, from all liabilities for injuries and damages whatsoever, arising from my presence or participation in the above described event(s) and do hereby grant the sponsors such release as described herein. I agree to indemnify, hold harmless and reimburse for future losses and Releasees and each of them, against any such claim that I or anyone or more of my or their executors, administrators, heirs, next of kin, successors, or assigns may assert, and against any costs, including attorneys' fees, with respect thereto. Such indemnification shall extend to any claim that might be asserted by others against me that also names the releases. The Release has been executed voluntarily and knowingly by me with the express intention of affecting the legal consequences provided by section 1541 of the California Civil Code. I intend to relinquish all claims against the releasees, whether or not known and expressly waive any and all right and benefits conferred upon me by the provisions of Section 1542 of the California Civil Code, which reads: 'A General Release does not extend to claims which the Creditor does not know or suspect to exist in his favor at the time of executing the Release which, if known by him, must have materially affected his settlement with the Debtor. This Release shall be governed by and constructed in accordance with the laws of the State of California. CODE OF ETHICS: SSS abides by good sportsmanship and expects the same from members, coaches and parents alike. In all SSS activities be safe, courteous, fair, controlled, and show respect to fellow surfers, officials, coaches, spectators, local residents and their property and the environment. The use of foul language, violence, illegal substance use is prohibited. Unsportsmanlike behavior will not be tolerated as per the SSS Basic Rules. Any display of poor sportsmanship by either a competitor, coach, or parent, shall be cause for automatic dismissal from the contest. This also applies to unsportsmanlike conduct directed to another competitor or official. No official of an event, in any capacity, shall at any time be subjected to unsportsmanlike conduct in either word or deed. Any display of poor sportsmanship by either a competitor, competitor’s parent or coach, shall be cause for automatic dismissal of the competitor and or coach from the contest. This also applies to unsportsmanlike conduct directed to another competitor or coach by any SSS competitor or coach. A second infraction will result in dismissal for the remainder of the season. Included is any correspondence via email, text message, FaceBook, Instagram and social media Postings or phone calls that are determined by the SSS to be threatening in nature, abusive or detrimental to the SSS/WSA in any manner. Any competitor practicing in the competition area or demonstrating unsportsmanlike conduct will be disqualified from the event, loss of points/standing in the event and a possible disqualification for the next event. Anyone surfing or in the water in the competition area without a jersey on will be disqualified and if it is a parent, the son/daughter competitor may also be disqualified. Coaching needs to come from the designated coach from the beach, not in the water, in a manner that is not disturbing or distracting to the other competitors, the judges, contest officials and the public. ASSUMPTION OF RISK, RELEASE AND WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT RELATING TO COVID-19 EXPOSURE, COVID-19 LIABILITY, AND COVID-19 RISKS IN CONSIDERATION for myself being permitted to utilize the services, utilize the facilities and/or participate in the programs of SCHOLASTIC SURF SERIES a division of WSA (the “Organization”), including, but not limited to, observation or use of facilities or equipment, or participation in or acting as a spectator during any program affiliated with the Organization, the undersigned, on behalf of himself or herself and such participating children and any personal representatives, heirs, and next of kin (hereinafter referred to as “the undersigned”) hereby acknowledges, agrees and represents that he or she has inspected and carefully considered such premises, equipment, and facilities and has considered the Organizations’ programs and that the undersigned finds and accepts same as being safe and reasonably suited for the use or participation by the undersigned and such participating children. In addition, the undersigned acknowledges that novel coronavirus (“COVID-19”) infections have been confirmed throughout the United States, including several cases in the undersigned’s own State and locality. In accordance with the most recent guidance and recommendations issued by the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), undersigned’s own State’s Department of Health (DOH) for slowing the transmission of COVID-19, the undersigned hereby agrees, represents, and warrants that neither the undersigned nor such participating children shall visit or utilize the facilities, services, and/or programs of the Organization (other than any exclusively online services and programs) within 14 days after (i) returning from highly impacted areas subject to a CDC Level 3 Travel Health Notice, (ii) exposure to any person returning from areas subject to a CDC Level 3 Travel Health Notice, or (iii) exposure to any person who has a suspected or confirmed case of COVID-19. The CDC Travel Health Network is continuously updating this list and the undersigned agrees that they are aware of this list and the countries listed. The undersigned agrees to check on a daily basis the CDC Travel Health Notices list (https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html) prior to participating in or utilizing the facilities, services, and programs of the Organization. The undersigned hereby agrees, represents, and warrants that neither the undersigned nor such participating children shall participate in, visit or utilize the facilities, services, and/or programs of the Organization if he or she (i) experiences symptoms of COVID-19, including, without limitation, fever, cough, loss of sense of taste or smell, or shortness of breath, or (ii) has a suspected or diagnosed/confirmed case of COVID-19. The undersigned agrees to notify the Organization immediately if he or she believes that any of the foregoing access/use restrictions may apply. The Organization has taken certain steps to implement certain recommended guidance and recommendations issued by public health agencies for slowing the transmission of COVID-19, including, without limitation, the access/use restrictions set forth above. The undersigned acknowledges and agrees that the Organization may revise its procedures at any time based on updated recommended guidance and recommendations issued by public health agencies and further agrees to comply with the Organization’s revised procedures prior to utilizing the facilities, services, and/or prior to participating in the programs of the Organization. The undersigned further acknowledges and agrees that, due to the nature of the facilities, services, and programs offered by the Organization, social distancing of 6 feet per person among children and their fellow participants or others is not always possible. The undersigned fully understands and appreciates both the known and potential dangers of participating in the programs and/or utilizing the facilities and services of the Organization and acknowledges that the use thereof by the undersigned and/or such participating children may, despite the Organization’s reasonable efforts to mitigate such dangers, result in exposure to COVID-19, which could result in quarantine requirements, serious illness, disability, and/or death. IN FURTHER CONSIDERATION OF BEING PERMITTED TO PARTICIPATE IN THE ORGANIZATION’S PROGRAMS, THE UNDERSIGNED HEREBY AGREES TO THE FOLLOWING: THE UNDERSIGNED, ON HIS OR HER BEHALF AND ON BEHALF OF SUCH PARTICIPATING CHILDREN, HEREBY RELEASES, WAIVES, DISCHARGES AND COVENANTS NOT TO SUE the Organization or its national governing body organization, or any of their respective directors, officers, employees, volunteers and agents, or any of the fellow participants or their family members or guests from all liability to the undersigned or such participating children and all personal representatives, assigns, heirs, and next of kin of the undersigned or such participating children for any loss or damage, and any claim or demands on account of any property damage or any injury to, or an illness or the death of, the undersigned or such participating children (or any person who may contract COVID-19, directly or indirectly, from the undersigned or such participating children) whether caused by the negligence, active or passive, of the Organization or otherwise while the undersigned or such participating children are in, upon, or about the premises or any facilities or using equipment of or participating in any program of or affiliated with the Organization. To the extent such statute applies, the undersigned also expressly and knowingly waives all rights under California Civil Code Section 1542, which provides: A general release does not extend to claims that the creditor or releasing party does not know or suspect to exist in his or her favor at the time of the executing the release and that, if known by him or her, would have materially affected his or her settlement with the debtor or released party. THE UNDERSIGNED HEREBY AGREES TO INDEMNFY, DEFEND AND HOLD HARMLESS the Organization or its national governing body organization, or any of their respective directors, officers, employees, volunteers and agents, and each of them, from any loss, liability, damages or costs they may incur, weather caused by the Organization’s negligence, active or passive, or otherwise while the undersigned or any participating child is participating in any program of the Organization or in, upon, or about the premises or any facilities or equipment affiliated with the Organization. The undersigned understands and agrees that the Organization is not required to provide insurance to cover the undersigned or such participating children in the event they suffer illness, injury, death, property loss, theft or damage of any sort upon, or about the premises or any facilities or equipment therein or while participating in any program affiliated with the Organization. The undersigned agrees and acknowledges that use of the Organization facilities and services, and participation in the Organization programs, may involve inherent danger and risk, including without limitation, the risk of physical illness or injury, death or property damage. THE UNDERSIGNED HEREBY ASSUMES FULL RESPONSIBILITY FOR, AND RISK OF ILLNESS, BODILY INJURY, DEATH OR PROPERTY DAMAGE to the undersigned or such participating children due to negligence, active or passive, or otherwise while in, about or upon the premises of the Organization and/or while using the premises or any facilities or equipment thereon and/or while participating in or observing any program affiliated with the Organization. The undersigned acknowledges that any illness or injuries that the undersigned or such participating children contract or sustain may be compounded by negligent first aid or emergency response of the Releasees and waive any claim in respect thereof. THE UNDERSIGNED further expressly agrees that the foregoing ASSUMPTION OF RISK, RELEASE AND WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT is intended to be as broad and inclusive as is permitted by the laws of the State in which the undersigned resides or participates and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. I HAVE CAREFULLY READ AND VOLUNTARILY SIGN THIS ASSUMPTION OF RISK, RELEASE AND WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT AND FURTHER AGREE THAT NO ORAL REPRESENTATIONS, STATEMENTS OR INDUCEMENT APART FROM THE FOREGOING WRITTEN AGREEMENT HAVE BEEN MADE. I AM AWARE THAT BY AGREEING TO THIS AGREEMENT I AM GIVING UP VALUABLE LEGAL RIGHTS, INCLUDING THE RIGHT TO RECOVER DAMAGES FROM THE ORGANIZATION IN CASE OF ILLNESS, INJURY, DEATH OR PROPERTY LOSS OR DAMAGE, INCLUDING, FOR THE AVOIDANCE OF DOUBT AND WITHOUT LIMITATION, EXPOSURE TO COVID-19 AT ANY ORGANIZATION FACILITY OR DURING PARTICIPATION IN ANY PROGRAM AND ANY ILLNESS, INJURY OR DEATH RESULTING THEREFROM. I UNDERSTAND THAT THIS DOCUMENT IS A PROMISE NOT TO SUE AND A RELEASE OF AND INDEMNIFICATION FOR ALL CLAIMS. IF SIGNING ON BEHALF OF MINOR: I ALSO UNDERSTAND THAT THIS AGREEMENT IS MADE ON BEHALF OF MY MINOR CHILD(REN) AND/OR LEGAL WARDS AND I REPRESENT AND WARRANT TO THE ORGANIZATION THAT I HAVE FULL AUTHORITY TO SIGN THIS AGREEMENT OF BEHALF OF SUCH MINOR(S). I have read and understand the terms of this Assumption of Risk, Release and Waiver of Liability, and Indemnity Agreement and agree to its terms.

CPR

Drop files here or

Please upload a scan or photo of your current CPR Certification.

First Aid

Drop files here or

Please upload a scan or photo of your First Aid Certification

School & Coach Information

Code of Ethics

Safe Sport Background Check