VANCOUVER ISLAND SOCIETY OF CRICKET UMPIRES AND SCORERS (VISCUS)
2021 WAIVER, RELEASE AND REGISTRATION FORM
PLEASE READ CAREFULLY BEFORE SIGNING – ALL FIELDS ARE MANDATORY
Emergency Contact Details:
Event: Cricket League and other competitions for 2021 (‘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.
WAIVER/RELEASE FOR COMMUNICABLE DISEASES INCLUDING COVID-19:
In consideration of being allowed to participate on behalf of VICTORIA & DISTRICT CRICKET ASSOCIATION (VDCA) athletic program and related events and activities, the undersigned acknowledges, appreciates, and agrees that:
Participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and,
I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,
I willingly agree to comply with the stated and customary terms and conditions for participation as regards protection against infectious diseases. If, however, I observe and any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,
I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD. HARMLESS, VICTORIA & DISTRICT CRICKET ASSOCIATION (VDCA) their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IF FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
FOR PARTICIPANTS OF MINORITY AGE (UNDER AGE 19 AT THE TIME OF REGISTRATION)
This is to certify that I, as parent/guardian, with legal responsibility for this participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of presence and participation and his/her personal responsibilities for adhering to the rules and regulations for protection against communicable diseases. Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to his/her release provided above for all the Releasees and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees for any and all liabilities incident to my minor child’s/ward’s presence or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent provided by law.
ADDITIONAL COVID - 19 PRACTICE & MATCH PRECAUTIONS
All players, coaches, members, volunteers, participants and family members of participants while in attendance at cricket activities (“Participants”) will be required to adhere to the following for each practice & match they participate in.
I agree to symptom screening checks, and will let my league / club know if I have experienced any of the symptoms in the past 14 days
I agree to stay home if feeling sick, and remain home for 14 days if experiencing COVID-19 symptoms.
I agree to sanitize my hands upon entering and exiting the facility, with soap or sanitizer.
I agree to sanitize the equipment I use throughout my practice with approved cleaning products provided by the league / club (shared and personal equipment).
I agree to continue to follow social distancing protocols of staying at least two (2) meters away from others.
I agree to not share any equipment during practice / game times.
I agree to abide by all of my league / clubs COVID-19 Policies and Guidelines.
I understand that if I do not abide by the aforementioned policies/guidelines, that I may be asked to leave the League / club for up to 14 days to help protect myself and others around me.
I acknowledge that continued abuse of the policies and/or guidelines may result in suspension of my club membership temporarily.
I acknowledge that there are risks associated with entering club facilities and/or participating in club activities, and that the measures taken by the club and participants, including those set out above and under the COVID-19 Response Plan and Return to Sport Protocols, will not entirely eliminate those risks
In addition, prior to each match or practice I agree to attest that:
I have not travelled internationally in the past fourteen (14) days.
I have not travelled outside the Province of British Columbia in the past fourteen (14) days.
I have not travelled to an area highly impacted by COVID-19 within my Province in the past fourteen (14) days.
I have not and do not believe that I have been exposed to a person with a confirmed or suspected case of COVID-19.
I attest that:
I have not been diagnosed with COVID-19 OR
I have been diagnosed with COVID-19 and been cleared as noncontagious by provincial or local public health authorities (confirmation from a medical practitioner will be required and maintained in a confidential file by the organization)
I, THE UNDERSIGNED, HAVE READ AND UNDERSTOOD THE TERMS OF THE WAIVER AND RELEASE.
, 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!