Central Sports Club Waiver Form

RELEASE OF LIABILITY, WAIVER OF CLAIMS,
ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT BY EXECUTING THIS YOU
WILL WAIVE CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE PLEASE
READ CAREFULLY

I understand and acknowledge that the
sport may involve physical risk. I understand that all sports offered
within Central Sports Club are played on surfaces whose condition are
variable and unpredictable and in weather, and man-made obstacles
which can change without notice, both of which could contribute to
the safety of play and result in serious personal injury.

RELEASE OF LIABILITY, WAIVER OF CLAIMS
AND INDEMNITY AGREEMENT

In consideration of the Releasees
(CSCKelowna, its owner and sponsors and all their respective agents,
officials, servants, contractors, representatives, directors, elected
and appointed officials, successors and assigns) allowing me to
participate in ball hockey at Central Sports Club, use its equipment
and facilities and providing its services and consultation, I hereby,
for my group, my heirs, executors, administrators, successors and
assigns agree as follows:

1. TO WAIVE ANY AND ALL CLAIMS that I
have or may in the future have against THE RELEASEES AND TO RELEASE
THE RELEASEES from any and all liability for any loss, damage,
expense or injury including death that I may suffer or that my
next-of-kin may suffer as a result of my participation in ball hockey
programs DUE TO ANY CAUSE WHATSOEVER, including but not limited to:

• negligence on the part of the
Releasees;

• breach of contract by the
Releasees;

• breach of warranty on the part of
the Releasees in respect of the design, manufacture, selection,
installation, maintenance or adjustment of equipment;

• breach of any statutory or other
duty of care including any duty of care owed under the Occupiers
Liability Act, R.S.B.C. 1996, c. 303, on the part of the Releasees;
and

• the failure on the part of the
Releasees to safeguard or protect me from the risks, dangers and
hazards of ball hockey, some of which are referred to in the
Assumption of Risks section of this Agreement.

I acknowledge having read and
understood the above release, waiver & indemnity (including the
attached COVID-19 waiver). I understand that any and all physical
activity that occurs within Central Sports Club requires physical
exertion and that I should consult a physician before participating
in this or any other strenuous physical activity.

Covid Waiver:

I agree to symptom screening checks,
and will let CSC know if I am experiencing any symptoms

I agree to stay home if feeling sick,
and follow the advice of the BC CDC and my local health authority

I agree that when I confirm my
attendance at a CSC ball hockey/floor hockey event I am agreeing to
the following:

- The participant is symptom free

- The participant has not travelled
outside of Canada within the last 14 days

- The participant is not caring for or
come into contact with anyone who is a presumptive case or confirmed
case of Covid-19

I agree to sanitize my hands upon
entering and exiting the facility, with soap or sanitizer

I agree to continue to follow social
distancing protocols of staying at least 2m away from others while
not within the playing surface with my cohort

I agree to not share any equipment
during practice or game times

I agree to abide by all CSC and member
associations COVID-19 Policies and guidelines.

I understand that if I do not abide by
the aforementioned policies/guidelines, that I may be asked to leave
CSC and member association for up to 14 days to help protect myself
and others around me.

I acknowledge that continued abuse of
the policies and/or guidelines may result in a suspension from CSC
ball hockey/floor hockey.

I acknowledge that there are risks
associated with entering the CSC facility and/or participating in CSC
activities, and that the measures taken by CSC and participants,
including those set out above and under the COVID-19 Response Plan
and Return to Sport Protocols, will not entirely eliminate those
risks.

I agree to FOREVER RELEASE CSCKelowna
AND OTHERS relating to becoming exposed to or infected by COVID-19
which may result from the actions, omission or negligence of myself
and others, including but not limited to CSCKelowna and other
participants in activities and sports offered by CSCKelowna.

I grant permission to CSCKelowna and
others to photograph and/or record my image and/or voice on still or
motion picture film and/or audio tape, and to use this material to
promote CSCKelowna through the media of newsletters, websites,
television, film, radio, print and/or display form. I waive any claim
to remuneration for use of audio/visual materials used for these
purposes. I understand that I may withdraw such consent at any time
by contacting CSCKelowna. CSCKelowna will advise the implications of
such withdrawal.

past events