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Waiver of Liability

A Waiver of Liability must be on file for each fencer prior to commencement of classes.
WAIVER OF LIABILITY (your signature is required)

Darien Fencing Club is a member of the United States Fencing Association.We carry the Association’s insurance coverage and recognize that fencing, like any sport, carries risk of injury.Therefore, in the event of an accident involving you/your child, we ask that you sign the following waivers attesting to your understanding of the risks involved and allowing Darien Fencing Club to obtain medical care in the case of injury when no parent or guardian is present.

This form will be valid for the 2016 fencing session, commencing September 11, 2016 through December 18, 2016

Name of Fencer ___________________________________________________________________________
(Please Print)

ASSUMPTION OF RISKS:Fencing is a physical activity which, by its very nature, carries with it certain inherent risk that cannot be eliminated regardless of the care taken to avoid injuries.Darien Fencing Club’s classes include activities that can involve strenuous exertions of strength using various muscle groups, quick movements involving speed and change of direction, and sustained physical activity which can place stress on the cardiovascular system.

The specific risks vary from one activity to another, but the risks range from minor injuries such as scratches, bruises, and sprains to major injuries such as eye injury, joint or back injuries, heart attacks and concussions.

WAIVER OF LIABILITY:In consideration of my child’s participation in the sponsored activities of Darien Fencing Club, I acknowledge, agree to and understand that: I am fully aware of and appreciate the risks, including the risk of serious injury, paralysis or death, associated with my child’s participation in a fencing class.I further agree on behalf of myself, my heirs, and personal representatives, that Darien Fencing Club, along with its coaches, volunteers, agents, and lessee of the premises, shall not be liable for any injury, loss of life or other loss or damage occurring as a result of my child’s participation in the club’s events, or as a result of equipment that may have been provided to me for those activities.

Fencer’s Signature ____________________________________________ Date ___/___/_____

Signature of Parent or Legal Guardian____________________________ Date ___/___/_____
Consent for Medical Treatment: This is to certify that I, __________________________ give my consent to the Darien Fencing Club and its representatives to obtain medical care from any licensed physician, hospital or clinic for the above named athlete for any injury or illness that may arise during activites associated with fencing classes at Darien Fencing Club.
Signature of Parent or Legal Guardian____________________________ Date ___/___/_____

Refund of Registration Fees :
The Darien Fencing Club Refund Policy is as follows:
A full refund of the registration fee is given if requested in writing before the first class. (Credit card fees are non-refundable.) There will be NO REFUND after the first class of the session for which you are registered.

Credit due to injury:

If a student becomes unable to participate in fencing class for which they have registered due to injury, please contact us, noting that a credit is being requested due to an injury. It is the policy of the Darien Fencing Club to offer class credits to those students that cannot participate in a fencing class for which they have registered only based on serious injury. These credits will be pro-rated from the time of written notification of the medical absence.
Tel: (203) 539-6359 Fax: (914) 307-1900

Download Waifer of Liability Form.