PARTICIPANT RELEASE (MINOR)
The undersigned, being a parent or legal guardian of the minor curler (“Minor”) indicated below,
hereby makes the follow representations: (i) that the undersigned is legally responsible for the Minor and
legally empowered to act for, on behalf of, and to execute this Participant Release and thereby bind the
Minor; (ii) that the Minor will comply with the rules and regulations of the Releasees (as defined below);
(iii) that the undersigned understands that the sport of curling is played on ice and requires physical
fitness; (iv) that the Minor possesses such physical fitness; and (v) that the undersigned understands that
the risks of the Minor participating in any curling activity could involve serious injury or death.
In consideration of the Minor being allowed access to the Ice House (as defined below) as a
participant in any curling activity in the Ice House, I, the undersigned, for the Minor and the Minor’s
estate, successors, heirs, beneficiaries, administrators, trustees, representatives, and attorneys do hereby
remise, release, acquit, and forever discharge (i) Brainerd Lakes Curling Association, a Minnesota nonprofit
corporation (the “Club”); (ii) Crow Wing County Fair Association (“CWCFA”); (iii) the United
States Curling Association, Inc. (“USCA”); (iv) the Minnesota Curling Association (“MCA”); (v) the
respective successors and assigns for each the Club, CWCFA, USCA, and MCA, and (vi) the respective
employees, officers, and directors, but only while acting in their capacity as such, of each the Club,
CWCFA, USCA, and MCA (collectively, the “Releasees”) from any and all actions, causes of action,
claims, demands, and liabilities, both in law and equity for damages and any court costs and legal
expenses and fees associated therewith in respect of physical, mental, and bodily injury occurring to the
Minor while participating in any curling activity in the Ice House prior to the Expiration Date (as defined
below): provided, however, that in the event such injury was caused, in whole or in part, by the wilful,
intentional, reckless, or grossly negligent action or failure to take action of any Releasee, such Releasee
shall not be so remised, released, acquitted, or discharged hereby; and provided, further, that nothing
herein shall be deemed to limit or exclude any action, cause of action, claim, demand, liability, payment,
reimbursement, other benefit, or any court costs or legal expenses and fees that the Minor or the Minor’s
estate, successors, heirs, beneficiaries, administrators, trustees, representatives, or attorneys might have
or seek against (a) the Club’s “Participant Medical Accident” insurance coverage, (b) any other
participant participating in any curling activity in the Ice House, or (c) against any other person or entity
other than a Releasee.
The Ice House shall mean the single room containing 4 sheets of ice in which the sport of curling
is playing in the building located at the2000 13th St SE, Brainerd, Minnesota owned and operated by one
or more of the Releasees. The Expiration Date shall mean the date which is one (1) calendar year after
the date this Release is executed below.
In the case that the Minor requires urgent medical attention and I cannot be reached, I hereby
authorize (I) emergency personnel and medical practitioners selected by any of the Releasees or other
chaperone of the Minor, in their reasonable judgement and sole discretion, to take any and all necessary
measures on behalf of the Minor and (ii) the disclosure of the information set forth below to emergency
personnel and medical practitioners by any of the Releasees or other chaperone of the Minor.
I hereby revoke and any all releases of liability, waivers, and indemnifications previously
executed by me in favor of any of the Releasees.
PARTICIPANT RELEASE
Page Two
BEFORE SIGNING BELOW, I WAS GIVEN THE OPPORTUNITY TO READ THIS PARTICIPANT
RELEASE AND TO CONSULT WITH AN ATTORNEY AS TO ITS SIGNIFICANCE. BY SIGNING
BELOW, I UNDERSTAND THAT I AM WAIVING SIGNIFICANT RIGHTS. I UNDERSTAND THE
MEANING OF THIS PARTICIPANT RELEASE AND THE RIGHTS I AM WAIVING.
NOTWITHSTANDING THE FOREGOING, I HAVE CHOSEN, OR MY OWN FREE WILL, TO
EXECUTE THIS PARTICIPANT RELEASE.
Dated: _________________________ ___________________________________________
Parent/Guardian
___________________________________________
Print Name
Name of Minor: _______________________________________________________________________
Address: _____________________________________________________________________________
Age: ________________________________________________________________________________
Medical Insurance Carrier: ______________________________________________________________
Policy/Group Number: _________________________________________________________________
Allergies, medical conditions, current medications: ___________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Emergency Contact Name and Relationship: ________________________________________________
Emergency Contact Telephone (s): ________________________________________________________
Revised 11-28-11
The undersigned, being a parent or legal guardian of the minor curler (“Minor”) indicated below,
hereby makes the follow representations: (i) that the undersigned is legally responsible for the Minor and
legally empowered to act for, on behalf of, and to execute this Participant Release and thereby bind the
Minor; (ii) that the Minor will comply with the rules and regulations of the Releasees (as defined below);
(iii) that the undersigned understands that the sport of curling is played on ice and requires physical
fitness; (iv) that the Minor possesses such physical fitness; and (v) that the undersigned understands that
the risks of the Minor participating in any curling activity could involve serious injury or death.
In consideration of the Minor being allowed access to the Ice House (as defined below) as a
participant in any curling activity in the Ice House, I, the undersigned, for the Minor and the Minor’s
estate, successors, heirs, beneficiaries, administrators, trustees, representatives, and attorneys do hereby
remise, release, acquit, and forever discharge (i) Brainerd Lakes Curling Association, a Minnesota nonprofit
corporation (the “Club”); (ii) Crow Wing County Fair Association (“CWCFA”); (iii) the United
States Curling Association, Inc. (“USCA”); (iv) the Minnesota Curling Association (“MCA”); (v) the
respective successors and assigns for each the Club, CWCFA, USCA, and MCA, and (vi) the respective
employees, officers, and directors, but only while acting in their capacity as such, of each the Club,
CWCFA, USCA, and MCA (collectively, the “Releasees”) from any and all actions, causes of action,
claims, demands, and liabilities, both in law and equity for damages and any court costs and legal
expenses and fees associated therewith in respect of physical, mental, and bodily injury occurring to the
Minor while participating in any curling activity in the Ice House prior to the Expiration Date (as defined
below): provided, however, that in the event such injury was caused, in whole or in part, by the wilful,
intentional, reckless, or grossly negligent action or failure to take action of any Releasee, such Releasee
shall not be so remised, released, acquitted, or discharged hereby; and provided, further, that nothing
herein shall be deemed to limit or exclude any action, cause of action, claim, demand, liability, payment,
reimbursement, other benefit, or any court costs or legal expenses and fees that the Minor or the Minor’s
estate, successors, heirs, beneficiaries, administrators, trustees, representatives, or attorneys might have
or seek against (a) the Club’s “Participant Medical Accident” insurance coverage, (b) any other
participant participating in any curling activity in the Ice House, or (c) against any other person or entity
other than a Releasee.
The Ice House shall mean the single room containing 4 sheets of ice in which the sport of curling
is playing in the building located at the2000 13th St SE, Brainerd, Minnesota owned and operated by one
or more of the Releasees. The Expiration Date shall mean the date which is one (1) calendar year after
the date this Release is executed below.
In the case that the Minor requires urgent medical attention and I cannot be reached, I hereby
authorize (I) emergency personnel and medical practitioners selected by any of the Releasees or other
chaperone of the Minor, in their reasonable judgement and sole discretion, to take any and all necessary
measures on behalf of the Minor and (ii) the disclosure of the information set forth below to emergency
personnel and medical practitioners by any of the Releasees or other chaperone of the Minor.
I hereby revoke and any all releases of liability, waivers, and indemnifications previously
executed by me in favor of any of the Releasees.
PARTICIPANT RELEASE
Page Two
BEFORE SIGNING BELOW, I WAS GIVEN THE OPPORTUNITY TO READ THIS PARTICIPANT
RELEASE AND TO CONSULT WITH AN ATTORNEY AS TO ITS SIGNIFICANCE. BY SIGNING
BELOW, I UNDERSTAND THAT I AM WAIVING SIGNIFICANT RIGHTS. I UNDERSTAND THE
MEANING OF THIS PARTICIPANT RELEASE AND THE RIGHTS I AM WAIVING.
NOTWITHSTANDING THE FOREGOING, I HAVE CHOSEN, OR MY OWN FREE WILL, TO
EXECUTE THIS PARTICIPANT RELEASE.
Dated: _________________________ ___________________________________________
Parent/Guardian
___________________________________________
Print Name
Name of Minor: _______________________________________________________________________
Address: _____________________________________________________________________________
Age: ________________________________________________________________________________
Medical Insurance Carrier: ______________________________________________________________
Policy/Group Number: _________________________________________________________________
Allergies, medical conditions, current medications: ___________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Emergency Contact Name and Relationship: ________________________________________________
Emergency Contact Telephone (s): ________________________________________________________
Revised 11-28-11
