"*" indicates required fields Participant InformationFull Name:* First Last Student ID Number:*Student Email:* Ex. abc@algonquinlive.comDate of Birth: YYYY dash MM dash DD Telephone Number:*Emergency ContactFull Name:* First Last Relationship to Participant:*Telephone Number:Informed Consent:Consent*I, the individual signing in this consent, for myself or a minor for whom I am signing this consent as parent or guardian (hereinafter referred to as the “Participant”), declare that the Participant intends to use or participate in some or all of the facilities, equipment, events, programs and services from time to time offered or made available (collectively referred in this document as “activities”) by The Students’ Association of the Algonquin College of Applied Arts and Technology Corporation (the “SA”) at its facilities from time to time on the campuses of the Algonquin College of Applied Arts and Technology or elsewhere off-site from time to time (any or all of them, individually and collectively referred to as the “Facilities”), including without limitation those at the Jack Doyle Athletics and Recreation Centre (the “ARC”), Algonquin Students’ Association Sports Field (the “SF”), and Algonquin Commons Theatre (the “ACT”) located at 1385 Woodroffe Avenue, Ottawa, ON, K2G 1V8. I understand that every individual (including me) has a different capacity for participating in such activities. I am aware that all activities are educational, recreational or self-directed in nature. I acknowledge that some activities or areas may be unsupervised, including among others, the locker and shower areas at the ARC. I assume full responsibility during and after any participation by Participant in activities and use of the ARC, and for the Participant’s choices to use or apply at Participant’s own risk any portion of the information or instruction received from or on behalf of the SA or its personnel. I hereby declare that the Participant is physically able to participate in any activities in which he/she/they chooses to participate, including without limitation any in or at the Facilities. I understand that part of the risk involved in the Participant undertaking any of the activities is relative to the state of fitness or health (physical, mental, or emotional) and to the awareness, care and skill with which the Participant conducts himself/herself/themself in any of the activities. In addition, I understand use of the Facilities and participation in any of the activities offered by the SA is entirely voluntary and the Participant is free to withdraw from, reduce or modify involvement in any of the activities and should do so on recognition of any signs of physical discomfort or illness (which may include, among other things, transient light headedness, fainting, chest discomfort, leg cramps, nausea, etc.). I further understand that personal injury or death is among the possible risks involved in participating in the activities or use of the Facilities. These possible risks may include, among other things, heart attack or stroke; aggravation of any existing or past injury, discomfort or problem with any other injury, discomfort or physical problem or injury associated with physical activity. By providing my initials below at the end of this paragraph, I confirm have read and understood the above possible risks associated with the Participant engaging in any the activities and use the Facilities and I consent to the above, including without limitation, all the above-noted risks. I understand.*Please Initial:*Release of Liability, Waiver of Claims, and Indemnity:Consent*I, the individual signing in this release for myself and/or any minor for whom I am signing this release as parent or guardian as the Participant, and our respective heirs, executors, administrators and assigns, release The Students’ Association of the Algonquin College of Applied Arts and Technology Corporation (the “SA”) and the Algonquin College of Applied Arts Technology, and their respective contractors, servants, agents, officers, directors, governors, academic and administrative and other employees and personnel, coaches and instructors and trainers (hereinafter collectively referred to as the “Releasees”) from any claims, demands, damages, actions or causes of action arising out of or in consequence of any loss, injury or damage to the Participant’s person or property incurred or arising from the activities, including any in or on the Facilites, whether incurred by me or any person for whom I am signing as a parent or guardian, and without limiting the generality of the foregoing, while participating in activities offered by the SA in, from or at the Facilities and whether in or on the grounds of the Facilities or incurred at any other location if offered remotely, notwithstanding that any such loss, injury or damage may have arisen by reason of my negligence or the negligence of the Participant or any of the Releasees, breach of contract, or breach of any statutory or other duty of care owing under occupiers liability legislation or otherwise. I covenant not to make or bring any such claim against any of the Releasees. I will defend, indemnify and hold harmless all releasees against any and all losses, damages, liabilities, deficiencies, claims, actions, judgments, settlements, interest, awards, penalties, fines, costs, or expenses of whatever kind, including reasonable legal fees, in connection with any third-party claim, suit, action, or proceeding arising out of or resulting from any of the activities. I understand.*Please Initial:*Consent:If any term or provision of this Consent, Release, Waiver & Indemnity is held to be invalid, illegal, or unenforceable in any jurisdiction, such invalidity, illegality, or unenforceability shall not affect any other term or provision of this Agreement or invalidate or render unenforceable such term or provision in any other jurisdiction. This Agreement shall be governed by and construed in accordance with the laws of the Province Ontario and the federal laws of Canada applicable therein. Any claim or cause of action arising under this Agreement may be brought only in the courts of the Province of Ontario, and I hereby consent to the exclusive jurisdiction of such courts. I declare that I have read, understood and agree to the above and to this Consent, Release, Waiver & Indemnity in its entirety. Full Name:* First Last Signature Date:* YYYY dash MM dash DD Please Initial:*CAPTCHA Δ