I agree, as consideration for the acceptance of my participation in events conducted by the University of Victoria Flying Club International (UVicFCI), to absolve and hold harmless the UVicFCI and any and all others involved and that I, and all parties on my behalf, agree that we will not sue the UVicFCI or any others involved as a result of the operation of or my participation in any UVicFCI event.
I assume full responsibility for any risk occurring from my participation. I assert that I have no physical condition that would preclude my participation.
I understand that participation in an UVicFCI event construes my acceptance of the risks inherent in such activities including, bodily injury, death, property damage, and any and all other risks. I assert that I have accident/health insurance coverage that will apply in the event of injury as a result of my participation. I consent to and will permit emergency treatment if required.
I assert that I am of legal age to contract or that my legal guardian has read and signed this release and waiver.
I give permission to use my name and likeness for advertisement. This waiver, release, and agreement applies to any and all UVicFCI events that I may participate in during 2001-2002/Sept.

Name______________________________________ Date___________________

Student’s Number __________________________

B.C CARE / Insurance # _____________________

Address____________________________________________________________

City _______________________________ State _________ ZIP _____________

Phone #  Home (____) _______ - ______________

Work (____) _______ - ______________

E-Mail ______________________________________

Signature ____________________________________