BLUE HILLS ASCENT REGISTRATION

Name:______________________________________________ Male:___ Female:___ Birthdate _____________

Street Address:__________________________________  City:______________________ 

State:________ Zip:_______________ Telephone: (              )                                                      

Select your event(s):    2K Classic Sprint only________    2K Classic Sprint + 12K Freestyle________
                                    12K Freestyle only________          8K Freestyle only________
                                    Sunday's Skating Technique Clinic________  

Name of your High School Team____________________________________

For the adult 12k race, wave seeding will be based on a recent Birkie time.  Here is your chance to request wave seeding by recording your recent result:
        Birkie pace min/k = ____min ____sec     Year of your race = ________
Those not requesting wave seeding will be placed in the subsequent waves on a first-come first-served basis.

Make checks payable to:
BLUE HILLS TRAIL ASSOCIATION, INC.
PO Box 251, Bruce, WI 54819

Acknowledgment and assumption of risk and release:

I, _____________________________________________________________ , know that alpine, nordic and freestyle skiing are action sports carrying significant risk of serious personal injury, death or property damage.  I also know that there are natural, mechanical and environmental conditions and risks which independently or in combination with my activities may cause property damage, or severe or even fatal injuries to me or others.

I agree that I am alone responsible for: (a) my safety while participating in competitive events and/or training for competitive events and (b) providing, utilizing and maintaining that equipment necessary for the safe enjoyment of my participation in such events and specifically acknowledge that the following persons or entities including the ski area, the promoters, the sponsors, the organizers, the promoters clubs, the officials and any agent, representative, officer, director, employee, member or affiliate of any person or entity named above are not responsible for my safety.  I specifically RELEASE and DISCHARGE, in advance, those parties from any liability whether, known or unknown, even that liability may arise out of negligence or carelessness on the part of persons or entities mentioned above.  I agree to accept all responsibility for the risks, conditions and hazards which may occur whether they be known or unknown.

Being fully aware of the risks, conditions and hazards of the proposed activity as a competitor, coach or official, I HEREBY AGREE TO WAIVE, RELEASE AND DISCHARGE any and all claims for damages or death, personal injury or property damage which I may have or which may hereafter accrue to me as a result of any participation in competitive events or training for competitive events, against any person or entity identified above whether such injury or damage was foreseeable or not, including any such claims regarding the design or condition of any equipment utilized by me in such competitive events without regard to whether such equipment is specified or recommended by such persons or entities identified above.

I further agree to forever HOLD HARMLESS and INDEMNIFY all persons and entities identified above, generally and specifically, from any and all liability for death, personal injury or property damage, resulting in any way from my participation in competitive events, or training for competitive events.

I currently have, and I agree to maintain throughout the time that I train and compete, valid and sufficient medical and accident insurance.  I understand that this is my sole responsibility and release all persons and entities identified above from providing this coverage for me.

I agree that I will accept and abide by the rules and regulations imposed by the organizers of any particular competition.  This Acknowledgment and Assumption of Risk and Release shall be binding upon my heirs and assigns.

Signature:_____________________________________________________________  Date:_________________________

By signing this Acknowledgment of Risk and Release as Parent/Guardian, I am consenting to the competitor’s participation in competitive skiing and training and acknowledge that I understand that any and all risk whether known or unknown, is expressly assumed by me and all claims, whether known or unknown, are expressly waived in advance.

______________________________________________________________      __________________________________
Signature of Parent/Guardian if competitor is under 18 years old                                         Date

Copyright 1998