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Waiver
Rico D'Anvers
2024-11-19T13:48:00+13:00
The BMX Collective: Rider Details & Waiver
Waiver
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Please fill this form out for each participant. This form is NOT to be used for multiple participants. Thank you | The BMX Collective
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I understand this is for one participant only
I have completed the BMX Collective waiver previously.
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Yes
No
Please select the type of training you are signing up for
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Select from the list
National's Phase
Please select the track you are signing up for
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Select from the list
Cambridge
Mountain Raiders
Taupō
Rider Name
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First
Last
What UCI age is your rider in 2025?
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Select from the list
8
9
10
11
12
13
14
15
16
17+
Contact Email
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This is the email address we will send training details to.
We typically group UCI 8–11 riders in the earlier session and UCI 12+ riders in the later session. If you can only attend a specific session time, please let us know in the box below.
We prioritise grouping riders based on age and ability, so we can't guarantee a preferred session time. We will try our best to accomodate your needs.
For those individuals under the age of eighteen (18) years (minor): As the parent and natural guardian or legal guardian of the participant, I hereby agree to the foregoing Waiver of Liability and Release for, and on behalf of, the participant (player/minor) named above. I hereby bind myself, the minor, and all other assigns to the terms of the Waiver of Liability and Release. I represent and certify that I have the legal capacity and the authority to act for, and on behalf of, the minor in the execution of this Waiver of Liability and Release.
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Participant is under the age of 18 and I am signing on their behalf
Participant is over age 18 and signing themselves
If the participant is under the age of 18, please provide the parent or legal guardian's FULL name that is agreeing to this liability waiver. If over 18, please state "N/A".
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The BMX Collective may take photographs/video footage at training. These could be used for analysis purposes by The BMX Collective coaching staff, placed on the The BMX Collective website, or for general media / publicity purposes. The name of your child will not be published without first seeking permission. Are you okay with this?
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Yes
No
Please indicate below if you (the athlete), or your child has any current or previous medical conditions, injuries, medication, dietary requirements or other needs that the The BMX Collective coaches needs to be aware of. Please give full details i.e. slipped disc/broken leg, allergies/asthma and medication required/supplied. If none, please state "N/A".
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Emergency Contact Name
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First
Last
Emergency Contact Relationship to Rider
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Emergency Contact Phone Number
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GP Name & Clinic
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Any additional notes
I confirm my consent to all terms and agreements from my previous waiver.
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I confirm
This form must be completed for each BMX athlete/rider (participant) and, if the athlete is under 18-years old, must be signed by the player’s parent or legal guardian. No rider will be allowed to participate in coaching/training without this form, properly executed, and on file. I, the undersigned, person agreeing on this form, in consideration for my participation in the The BMX Collective do hereby wilfully acknowledge that my agreement below attests to my understanding and agreement that: BMX Racing and training is a physical, contact, sport that involves the risk of injury. I assume all risks and hazards associated with my participation in the sport. I am in proper physical condition to participate in BMX training have no illness, disease or existing injury or physical defect that would be aggravated by my participation. If I do, I will list this below and I will inform my coach if this status changes. I further acknowledge that this risk may involve loss or damage to me or my property, including the risk of death, or other unforeseen consequences, including those which may be due to the unavailability of immediate emergency medical care. I will wear a full face helmet, long sleeved top, long pants, gloves fitted accordingly and properly fitted and appropriate shoes. The BMX Collective does not have personal injury insurance that covers my participation. Therefore, I participate in The BMX Collective at my own risk and The BMX Collective holds no responsibility to myself or property if injured or broken. Under any condition, I am responsible for any and all medical expenses arising from my participation, in training and racing and while travelling to and from these events. I have the right and responsibility to inspect the equipment and facilities prior to training and, if I believe that anything may be unsafe, I will advise the coach or supervisor of the condition and may refuse to participate. Participation assumes consent. I hereby release, waive liability, discharge, hold harmless, indemnify, and covenant not to sue The BMX Collective employees, coaches, trainers, volunteers, sponsors and advertisers, and other agents, estates or executors, from any and all liability incurred in the conduct of, and my participation in, their BMX programs. I have completely read this document and fully understand its contents. I acknowledge that I have given up substantial rights by accepting this document and that I do so voluntarily. My agreement to this form attests to this on behalf of myself and my executors, personal representatives, administrators, heirs, next-of-kin, successors, and assigns.
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I have read the waiver liability protection form, understand and agree to the terms by ticking this box as my form of signature.
I disagree and will not participate
Submit Waiver
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