Cold Knight Club Registration 2019
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Last Name *
First Name *
Student ID Number *
Calvin Email Address *
Year at Calvin *
Will this be your 4th time jumping? *
Waiver and Release of Liability
By signing, I acknowledge that my participation in the Cold Knight Club jump into the Seminary Pond ("Event") involves subjecting my body to contact with ice and very cold water that may be hazardous. I certify that I am medically able to withstand the jump into the water and I expressly assume all known and unknown risks associated with the Event. In consideration of my participation in the Event, I, for myself, my heirs, executors, administrators, personal representatives, successors, and assigns 1) WAIVE AND RELEASE ANY AND ALL RIGHTS, CLAIMS, AND CAUSES OF ACTIONS I have or may have against K4L, Calvin College, Calvin Theological Seminary, the Calvin College Alumni Association ("Calvin"), The City of East Grand Rapids, and the East Grand Rapids Department of Public Safety,  that may arise as a result of my participation in the Event and 2) agree to INDEMNIFY, DEFEND, AND HOLD HARMLESS Calvin and East Grand Rapids from and against any and all injuries, losses, causes of action, liabilities, damages, and/or expenses that may arise out of or resulting from, directly or indirectly, my participation in the Event unless caused by the gross negligence or willful misconduct of Calvin. I hereby grant to Calvin the right, permission, and authority to use my name, image, voice, and/or likeness, without compensation, captured during the Event by Calvin, its affiliated entities or contractors, and/or the media in any photographs, videotapes, CDs, DVDs, broadcast, telecast, podcast, webcast, recordings, motion pictures, commercial advertisement, promotion materials, and/or any other record of this Event, including any information collected about me by Calvin for this Event, for any purpose whatsoever. I acknowledge and agree to abide by the rules of the Event that may be posted by Calvin or on Calvin's website or otherwise communicated to me verbally or in writing. I hereby represent and warrant that I am 18 years of age or older or, if applicable, that I am the parent or legal guardian of the child under the age of 18 who I am registering for the Event and that I have the full power and authority to agree to these terms on behalf of such child, and to bind him/her to these terms.
By entering today's date below, it acts as my electronic signature that I agree to the terms and conditions listed above, either for myself or as the parents or legal guardians of a participant under the age of 18. *
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