PRC Waiver Rev

PALMETTO ROWING CLUB
CONSENT AND RELEASE FROM LIABILITY FORM
Activity, as used herein, shall include any organized, supervised or authorized rowing activities, on or
off the water, in which a member or guest of Palmetto Rowing Club (PRC) or an affiliated
group may engage.
INSTRUCTIONS
1. Persons age 18 and over, complete PART A only.
2. Persons under age 18 must complete PART A and have parent or guardian
complete PART B.
PART A – CONSENT AND RELEASE FROM LIABILITY

I agree to abide by and be bound by the statements and representations below pertaining
to my membership, or my participation if not a member, in activities of the Palmetto
Rowing Club.
1. I currently have no known physical or mental condition that would impair my

capability for full participation in rowing activities as intended and expected of
me. I further agree to notify an officer or director of PRC of any change in my
condition which might affect my ability to participate safely.
2. I am able to successfully meet the floating and swimming requirements of the
PRC Water Safety Test (float, tread water or swim in place for five minutes
immediately followed by swimming a distance of 50 meters) and I am capable of
maneuvering freely in rapidly flowing waters.
3. I understand and appreciate that participation in rowing activities, despite all
reasonable precautions implemented for my safety as a participant, carries a
risk of serious injury, including permanent disability, illness, paralysis and death
(“Risks and Dangers”). These Risks and Dangers may be caused by my own
actions or inactions, the actions or inactions of others participating, the
conditions in which the rowing activities take place, or the negligence of the
Releasees named below. In addition, there may be other risks and social or
economic losses that may be incurred by me which are either not known to me
or readily foreseeable at this time.
4. I fully accept and assume all such Risks and Dangers and all responsibility for
losses, costs and damages as a result of my participation in PRC rowing and
related activities.
5. I hereby release, discharge and forever waive any causes of actions, suits,
claims and demands whatsoever, including deemed negligent rescue
operations, in law or in equity, which I may have or which my heirs, executors or
administrator may hereafter have against PRC, US Rowing, or any of their
officers, directors, governors or advisors, any affiliated group or any
individual or entity holding legal title to any property or premises upon which
organized rowing and club related activities are conducted (each considered
one of the “Releasees” herein), or any PRC or US Rowing sanctioned event,
excepting any causes of actions of claims resulting from gross negligence. I
understand that this will preclude me from suing in the event I am accidentally
injured. I further agree that if, despite this release and waiver of liability and
assumption of risk, I, or anyone on my behalf, makes a claim against any of the
Releasees, I will indemnify, save and hold harmless each of the Releasees from
any litigation expenses, attorney fees, loss, liability, damage or cost which any
may incur as a result of such claim to the fullest extent permitted by law.
6. I agree to abide by the general rules of conduct prescribed by PRC for
participation in their rowing and club related activities.
7. I agree to assume financial responsibility for any health, accident or any other
personal loss incurred while participating in or as a result of rowing activities
that are not covered by my insurance and other insurance coverage that may be
provided to all participants in these activities.
Name (Please Print) __________________________________________

DOB_____________________________________________ __________
Address _________________________________ ___________________
City_____________________________State________ZIP____________
e-mail ______________________________________________________
Telephone __________________________________________________
Cell Phone__________________________________________________
Signature___________________________________________ ________
Date _______________________________________________________
PART B: PARENTAL/ LEGAL GUARDIAN CONSENT AND RELEASE FROM LIABILITY:

I, the minor's parent and/or legal guardian, understand the nature of rowing activities and the
minor's experience and capabilities and believe the minor to be qualified to participate in the
rowing activities and to understand and abide by the Safety Rules for Participants. I hereby
release, discharge, covenant not to sue, and AGREE TO INDEMNIFY AND HOLD
HARMLESS each of the Releasees from all liability, claims, demands, losses, or damages on
the minor's account caused or alleged to be caused in whole or in part by the negligence of the
Releasees or otherwise, including negligent rescue operations, and further agree that if,
despite this release, I, the minor, or anyone on the minor's behalf makes a claim against any of
the above Releasees, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS each of the
Releasees from any litigation expenses, attorney fees, loss liability, damage, or cost which any
Releasee may incur as the result of any such claim to the fullest extent permitted by law.
Name (Please Print) _________________________________________ _

Address __________________________________________________ __
City_____________________________State________ZIP____________
e-mail ______________________________________________________
Signature_________________________________________________ __
Date _______________________________________________________
(Revised August 2020)

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PALMETTO ROWING CLUB

CONSENT AND RELEASE FROM LIABILITY FORM

PART A – CONSENT AND RELEASE FROM LIABILITY

1. I currently have no known physical or mental condition that would impair my

Name (Please Print) __________________________________________

PART B: PARENTAL/ LEGAL GUARDIAN CONSENT AND RELEASE FROM LIABILITY:

Name (Please Print) _________________________________________ _

(Revised August 2020)

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