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Registration fee is $15

VANCOUVER ISLAND SOCIETY OF CRICKET UMPIRES AND SCORERS (VISCUS)

2022 WAIVER, RELEASE AND REGISTRATION FORM

PLEASE READ CAREFULLY BEFORE SIGNING – ALL FIELDS ARE MANDATORY

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Emergency Contact Details:

Event: Cricket League and other competitions for 2022 (‘Event’) organized by Cricket BC or by the Victoria & District Cricket
Association (‘VDCA’), or by any other body that has requested officials (Umpires and/or Scorers) from the VISCUS.


In consideration of VISCUS accepting me as a registered member of the Society to officiate at the Event, I, for myself, my heirs,
executors, administrators and assigns WAIVE any claims to which I may become entitled for injury or damage and HEREBY
RELEASE VISCUS and all the participants in the Event and all other organizers, executives, sponsors, representatives, agents,
employees and any other person or organization assisting in this Event from any claims for damages or injuries suffered to me
as a result of my participation in the Event including conditions of the pitch and the field, whether or not caused by negligence
and/or howsoever caused including recklessness or omission of any such parties.


I understand that there are inherent and other risks involved in the Event and all injuries are a common and ordinary occurrence and I freely assume those risks and accept full responsibility for any and all such damage or injury which may result.


I understand that I am required to maintain valid provincial Medical Services Plan coverage (or similar private medical insurance) to remain eligible for insurance coverage under any policy held by the VDCA. I understand that under the terms of the current insurance policy held by the VDCA, cricket related damage to vehicles belonging to cricketers, both players and officials, shall not be covered during the course of a game or at practices.


I confirm that I am in proper physical condition to participate in the Event and I am aware that my participation could, in some
circumstances, result in physical injury. I confirm that I shall adhere and comply with the VDCA’s Code of Conduct and that I
agree to the email address stated above to be used for communications with me from the VISCUS.


I have been recommended to obtain legal advice before signing this WAIVER AND RELEASE.

I, THE UNDERSIGNED, HAVE READ AND UNDERSTOOD THE TERMS OF THE WAIVER AND RELEASE.

Dated in the city of: 

, in the Province of British Columbia, on this date

Personal data on this form will be held confidentially by the VDCA. All online payments are deposited into the VDCA Bank Account through a Secure SSL Stripe Canada Payment App.

Thanks for Registering with VISCUS!