Official Entry Form and Waiver

Sunday May 28, 2016

Official Entry Form and Waiver

• This years race will benefit the Laura Foundation in Madison, NH
• Registration and check in starts at 10am at the Eastern Slope Camping Area
• Pre-registration is recommended
• The race starts at the First Bridge on River Road in North Conway, NH.
• The Conway Fire Department’s “Swift Water Rescue Team” will be monitoring the river prior to and during the race, along with other volunteers.
• The course is approximately 8 miles long and finishes at the Eastern Slope Camping Area in Conway, NH
• The entry fee includes coffee and breakfast snacks at the registration station along with the cookout after the race. For those that would like to join family and friends at the cookout, but not participate in the race, there will be a small fee of $5
• Eastern Slope Camping Area will have kayak and canoe rentals if needed. Canoe and kayak rentals include a life jacket, paddle and transportation. Contact the Eastern Slope Camping Area at 603-447-5092 or for more information.
• First, second and third place medals will be awarded in each of the 8 categories
• All participants MUST wear a USCG approved PFD at ALL TIMES during the race.
• All participants under the age of 18 must have a completed consent form to be eligible to participate
• Please return the attached registration form to the address listed at the bottom. One entrant per form.

Conway Area Lions Club

Second Annual Saco River Kayak and Canoe Benefit Race 2017

Participant Information(one per form)

Name:______

Address:______

City, State, Zip______

Phone:______

Race Category______

IN CONSIDERATION of and as a condition of being allowed to participate in the Saco River Kayak and Canoe Race, I, for myself, my personal representatives, assigns, heirs and next of kin: 1. AGREE, acknowledge and represent that I understand that canoeing and kayaking activities are inherently dangerous and that I am qualified to participate in such activities, in good health, and in proper physical condition. I further acknowledge that the activity will be conducted over waterways open to the public during the activity and that hazards in the river are to be expected. I realize that injuries may occur. Further, I am fully responsible for all of my safety apparel such as a life preserver while engaging in this activity; 2. FREELY accept and voluntarily assume all risks of personal injury or death or property damage, and RELEASE & DISCHARGE the Town of Conway, Lions Club International and the Conway Area Lions Club, Eastern Slope Camping Area, and their agents, employees, members, directors, officers, shareholders, and assigns from any and all liability for personal injury, death, or property damage which results in any way from negligence; 3. FURTHER AGREE that if, despite this Agreement, I or anyone on my behalf makes a claim against the Town of Conway, Lions Club International and the Conway Area Lions Club, Eastern Slope Camping Area their agents, employees, members, directors, officers, shareholders, and assigns, I will INDEMNIFY, SAVE AND HOLD HARMLESS the Town of Conway, Lions Club International and the Conway Area Lions Club, Eastern Slope Camping Area, their agents, employees, members, directors, officers, shareholders, and assigns from any litigation expenses, attorneys fees, loss, liability, damage or cost which may result from such claim. I have read this Agreement, fully understand its terms, and understand that I have given up substantial rights and am receiving a substantial benefit for participating in the race activities. I fully release the Town of Conway, Lions Club International and the Conway Area Lions Club, Eastern Slope Camping Area, their agents, employees, members, directors, officers, shareholders, and assigns from any and all liability for personal injury, death and property damage which results in any way from negligence.

Signed:______Printed Name:______Date:______

For participants under 18 years of age

I, ______do hereby give my consent for______to participate in the Saco River Kayak and Canoe Benefit Race and further release the Town of Conway, Lions Club International and the Conway Area Lions Club, Eastern Slope Camping Area their agents, employees, members, directors, officers, shareholders and its inhabitants from all claims, demands or charges on account of any injury to persons or property that may result by virtue of said minor’s participation in this event

Signed:______Printed name:______Date:______

Payment Information: