PARTICIPATION AGREEMENT AND GENERAL RELEASEParticipation Agreement and General Release • May 16th, 2014 • Minnesota
Wai Nani Surf & Paddle, LLC, a Minnesota limited liability company (“WNSP”), provides stand up paddle boarding instruction, services and equipment to its customers. Stand up paddle boarding (“SUP”) / kayaking is an inherently dangerous sport or activity. Therefore, WNSP will not provide SUP instruction, services or equipment to any customer unless and until the customer has fully executed this Participation Agreement and General Release (“this Agreement”) and delivered it to WNSP. This Agreement shall cover and apply to all SUP engaged in by Participant by or through WNSP and shall continue to be in full force and effect indefinitely and not just for any particular class, day, season or year.
PARTICIPATION AGREEMENT AND GENERAL RELEASE FORM FOR ANOKA COUNTY VOLUNTARY SEPARATIONParticipation Agreement and General Release • December 28th, 2011
I, (Employee: print or type your name) , the undersigned Employee (“Employee”) voluntarily agree to resign or retire under Anoka County’s 2011 Voluntary Separation Incentive Program for (“Incentive Program”) for eligible employees and to execute this General Release of all Claims (the “Release”). For purposes of this Participation Agreement and General Release, the term “County” refers to Anoka County and includes the County’s past, present and future officers, officials, employees, volunteers and agents.
Participation Agreement and General ReleaseParticipation Agreement and General Release • September 30th, 2022
Intern/Observer/Participant Information Name Date of Birth Sex Parent’s/Guardian’s Name (if under 18 years of age) Parent’s/Guardian’s Name (if under 18 years of age) Home Phone ([ ]) Work/Cell Phone ([ ]) Home Phone ([ ]) Work/Cell Phone ([ ]) Address Address City, ST ZIP Code City, ST ZIP Code Emergency Contacts Primary Emergency Contact Secondary Emergency Contact Home Phone ([ ]) Work/Cell Phone ([ ]) Home Phone ([ ]) Work/Cell Phone ([ ]) Medical Information and Emergency Treatment Authorization for Participants ANYONE REQUIRING IMMEDIATE MEDICAL ATTENTION WILL BE TAKEN TO THE MOST APPROPRIATE MEDICAL FACILITY. Primary Care Physician’s Name Phone Number Insurance Company Policy Number In the case of an emergency, I authorize all medical and surgical treatment, X-ray, laboratory, anesthesia, and other medical and/or hospital procedures as may be performed or prescribed by the attending physician and/or paramedics and waive my right to informedconsent of treatment. I acknowledge tha
Participation Agreement and General ReleaseParticipation Agreement and General Release • February 22nd, 2023
Intern/Observer/Participant Information Name Date of Birth Sex Parent’s/Guardian’s Name (if under 18 years of age) Parent’s/Guardian’s Name (if under 18 years of age) Home Phone ([ ]) Work/Cell Phone ([ ]) Home Phone ([ ]) Work/Cell Phone ([ ]) Address Address City, ST ZIP Code City, ST ZIP Code Emergency Contacts Primary Emergency Contact Secondary Emergency Contact Home Phone ([ ]) Work/Cell Phone ([ ]) Home Phone ([ ]) Work/Cell Phone ([ ]) Medical Information and Emergency Treatment Authorization for Participants ANYONE REQUIRING IMMEDIATE MEDICAL ATTENTION WILL BE TAKEN TO THE MOST APPROPRIATE MEDICAL FACILITY. Primary Care Physician’s Name Phone Number Insurance Company Policy Number In the case of an emergency, I authorize all medical and surgical treatment, X-ray, laboratory, anesthesia, and other medical and/or hospital procedures as may be performed or prescribed by the attending physician and/or paramedics and waive my right to informed consent of treatment. I acknowledge th
PARTICIPATION AGREEMENT AND GENERAL RELEASEParticipation Agreement and General Release • March 7th, 2016 • Oregon
Two Seven Zero, LLC, an Oregon limited liability company, provides stand up paddle boarding instruction, services and rental equipment to its customers. Stand up paddle boarding (“ SUP”) is an inherently dangerous sport or activity. Therefore, Two Seven Zero LLC will not provide SUP instruction, services or equipment to any customer unless and until the customer has fully executed this Participation Agreement and General Release (“this Agreement”) and delivered it to Two Seven Zero LLC. This Agreement shall cover and apply to all SUP engaged in by Participant by or through Two Seven Zero LLC and shall continue to be in full force and effect indefinitely and not just for any particular class, day, season or year. Participant named below desires to receive SUP instruction, services and/or equipment from Two Seven Zero LLC. In connection therewith, Participant acknowledges and agrees as set forth above and as follows:
