WESTERN NEW YORK OFFSHORE POWERBOAT ASSOC., INC BUFFALO POKER RUN - AUGUST 7-8, 2015

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1 WESTERN NEW YORK OFFSHORE POWERBOAT ASSOC., INC BUFFALO POKER RUN - AUGUST 7-8, 2015 ASSUMPTION AND ACKNOWLEDGMENT OF RISK AND RELEASE OF LIABILITY WAIVER 1. ALL OF THE UNDERSIGNED, DO HEREBY AFFIRMATIVELY AND KNOWINGLY, RELEASE, WAIVE(S) AND COVENANT(S) NOT TO SUE the Western New York Offshore Powerboat Association, Inc. (WNYOPA), the promoters, participants, Poker Run Clubs or organizations, other sanctioning organizations, or any subdivision, thereof, site operators, volunteers, participants, rescue personnel, any person in any restricted area, sponsor, advertisers, owners or lessee of premises use to conduct the event(s), premises and event staff, underwriters, consultants and others who give recommendations, directions or instructions or engage in risk evaluation or loss control activities regarding the premises event(s) and each of them, the directors, officers, agents and employees, all for the purposes herein referred to as Releasees, FROM ALL LIABILITY TO THE UNDERSIGNED, his personal representatives, successors, assigns, heirs and next of kin FOR ANY AND ALL LOSS OR DAMAGE, AND ANY CLAIMS OR DEMANDS THEREOF ON ACCOUNT OF INJURY TO THE PERSON OR PROPERTY OR RESULTING IN DEATH OF THE UNDERSIGNED ARISING OUT OF OR RELATED TO THE EVENT(S), WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE. 2. ALL OF THE UNDERSIGNED, DO HEREBY AFFIRMATELY AND KNOWINGLY AGREE TO INDEMNIFY, SAVE AND HOLD HARMLESS ALL OF THE parties, entities or groups in paragraph one (1) above and releases each of them FROM ANY LOSS, LIABILITY, DAMAGE OR COST they may incur arising out of or related to the EVENT(S) WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE. 3. ALL OF THE UNDERSIGNED, DO HEREBY AFFIRMATELY AND KNOWINGLY, ASSUME FULL RESPONSIBILITY FOR ANY RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE arising out or related to the EVENT(S), WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE. 4. ALL OF THE UNDERSIGNED, DO HEREBY, AFFIRMATELY AND KNOWINGLY, ACKNOWLEDGE THAT THE ACTIVITIES OF THE EVENT(S) INVOLVE THE RISK of serious injury and/or death and or property damage. Each of the UNDERSIGNED also expressly acknowledges that INJURIES RECEIVED MAY BE COMPOUNDED OR INCREASED BY NEGLIGENT RESCUE OPERATIONS OR PROCEDURES OF THE RELEASEES. 5. ALL OF THE UNDERSIGNED, DO HEREBY, AFFIRMATELY AND KNOWINGLY, ACKNOWLEDGE and agree that this Release and Wavier of Liability, assumption of Risk and Indemnity Agreement extends to all acts of negligence by the Releasees, INCLUDING NEGLIGENT RESCUE OPERATIONS and is intended to be as broad and inclusive as is permitted by the laws of the Province or State or jurisdiction in which the EVENT(S) is/are conducted. If any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. 6. ALL OF THE UNDERSIGNED, DO HEREBY, grant permission to the Western New York Offshore Powerboat Association Inc. is NOT A RACE and does not involve or require the participants to be involved in any RACING ACTIVITY. Each participant will use their own judgment and experience to determine prudent speed of travel for all conditions and will obey ALL SAFE POWERBOATING GUIDELINES, REGULATIONS AND LAWS. 7. ALL OF THE UNDERSIGNED, DO HEREBY, grant permission to the Western New York Offshore Powerboat Association, Inc. sponsors, event sponsors, event promoters, photographers and their assigns, to use their voice and/or likeness, photographs and photographs of their performance boat in advertising and promotion material, feature use including radio, television, motion picture film, video tape, DVD s, newspaper, magazines, programs, and all other media in connection with advertising and purposes of trade. THE UNDERSIGNED IS A MEMBER IN GOOD STANDING OF THE WNYOPA AN HAS APPLIED FOR MEMBERSHIP IN THE WNYOPA, and agrees to abide by they WNYOPA Rule Book and Safety Guidelines, as these rules may be amended or interpreted from time to time. 1

2 I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE OR GUARANTEE MADE TO ME. I INTEND MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW. BY SIGNING BELOW, EACH OPERATOR AND PASSENGER AGREES TO THE TERMS OF THIS RELEASE OF LIABILITY WAIVER. PRINTED NAME SIGNATURE DATE AGE SEX OPERATOR OR PASSENGER? BOAT NAME TITLED OWNER NAME TO BE COMPLETED BY TITLED OWNER OF PARTICIPATING VESSEL ONLY: Please provide us with the following details: Your legal name: Your residence address: Your intended top speed at any point in time for the event: MPH The top capable speed of your vessel: MPH Your vessel s engines info: # of engines Total HP per engine: Manufacturer of engine(s): Are your engines supercharged? Yes No (please circle one) Operators for event: Driver full legal name: Throttle person full legal name: 2

3 We would like to take this moment to remind you of a few Buffalo Poker Run rules that by signing below you are affirming that you understand and agree to abide by the rules and regulations set forth by WNYOBA, Inc.: - Each driver must agree that he will not have consumed alcohol nor taken any illegal nor mind or reflex altering substances 6 (six) hours before the event and will not consume either while operating the boat. - Each boat based their planned top speed is to adhere to the following passenger restrictions: 0 to 70 mph is to have all persons on board 18 years of age and younger be accompanied by a parent or legal guardian while the boat is being operated. 71 mph to 110 mph is limited to all passengers being over 19 years of age. 110 mph or faster as not allowed to have back seat passengers and all persons on board must be over 18 years of age. - By signing below you agree and confirm that you are aware of the local boating laws associated with the body of water in which you are operating on during the Buffalo Poker Run. You furthermore agree to obey all local boating laws. - Personal Flotation Devices (PFD s/life Jackets) are mandatory and are to be worn by all boat occupants during the event while each boat is being operated. - No alcohol may be on board the vessel while boat is being operated during the Buffalo Poker Run. We maintain a zero tolerance policy. Should you be found to be in violation of this policy you will be disqualified and removed from the event without refund. - You affirm that the insurance declarations page submitted by you is currently paid to date and enforce you carry a minimum liability limit of $300,000. Driver s Signature: DATE: 3

4 SCHEDULE A THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: MARINE GENERAL LIABILITY COVERAGE PART ALL OTHER TERMS AND CONDITIONS REMAINED UNCHANGED. NAMED INSURED: POLICY NUMBER: BUFFALO POKER RUN WESTERN NEW YORK OFFSHORE POWER BOAT ASSOC., INC. CSR Reference No A EFFECTIVE DATE: 08/09/ /11/2013 ENDORSEMENT NO.: SCHEDULE A It is hereby understood and agreed it is a condition of this policy that the following additional Warranties applies: 1. Must advise all public and local businesses along the event route of the event and the event course route in no less than 30 days of the event and continue with periodical updates of no less than one week apart. 2. Each boat owner must provide the following to the insured at the time of registration (insured is to furnish each card stop with same information): a. Owner s name & address; b. Boat name, year, length, make model, engine description and registration number; c. Current water craft liability insurance company name, policy number and expiration date; d. Intended top speed; e. Driver and throttle person s name(s); and f. Name, age & sex of all passengers to be aboard their vessel at any time during the event. 3. Each driver and all boat occupants must sign an assumption and acknowledgment of risk and release of liability agreement clause which contains the boat s intended operating speed as well as the boat s top speed and you shall retain same for a period of no less than 6 years and furnish the same to us upon our request. Should any minor(s) be participating in any activities, that minor(s) parent or legal guardian must also sign such said agreement. Minors are not permitted to participate in any shootout/radar run type of event. The agreement must have been worded for you by your attorney, familiar with the laws of your state. 4. Each driver and throttle person must agree in writing that they will not have consumed alcohol or taken any illegal nor mind or reflex altering substance 6 (six) hours before an event and will not consume either while operating the boat. 5. Each boat based on their planned top speed is to adhere to the following passenger restrictions: a. 0 to 70 mph is to have all persons on board 18 years of age and younger be accompanied by a parent or legal guardian while the boat is being operated. Passengers are not allowed in the backseat during any shootout/radar run event. b. 70 mph to 110 mph is limited to all passengers being over 18 years of age. Passengers are not allowed in the backseat during any shootout/radar run event. c. 110 mph or faster are not allowed to have back seat passengers and all persons on board must be over 18 years of age. SCHEDULE A 4

5 6. Requests the service of the local United States Coast Guard or the local United States Coast Guard Auxiliary for spectator safety when registered boats are being operated on the event course route, which are designated as navigable waters or waters where the local United States Coast Guard or the local United States Coast Guard is capable of having jurisdiction, during the event. A participant list containing boat information per item 2 a, b, e, and f is to be provided to the local United States Coast Guard or the local United States Coast Guard Auxiliary so as to easily identify registered boats from spectator boats. 7. Requests the service of local law enforcement marine patrol for spectator safety when registered boats are being operated on the event course route during the event. A participant list containing boat information per item 2 a, b, e, and f is to be provided to local marine patrol so as to easily identify registered boats from spectator boats. 8. Identify and make all participants aware of local boating laws and require each participant to agree, in writing, to obey all boating laws. You shall retain same for a period of no less than 6 years and furnish same to us upon our request. 9. Designate a Safety Officer that has been introduced to all participants and is easily identifiable at all times who will be the focal point for implementing Safety policies and procedures before, during and after the event. 10. Maintain clearly identifiable safety boats along the event course route during the event when registered boats are being operated during the event. 11. Personal Floatation Devices (PFDs/Life Jackets) are mandatory and are to be worn by all boat occupants during the event while each boat is being operated. 12. No alcohol in boats while boats are being operated and maintain a zero tolerance policy. 13. Maintain a minimum distance of 200 yards between outer most participant course boundary line and inner most spectator area boundary line, facing participant course, during the shootout/radar run event. Coverage under this policy does not apply to any type of racing or speed contest, except for shootouts/radar runs if approved by the company and specifically made part of this policy. Further, failure to comply with all the foregoing terms and conditions renders this policy and coverage under same null and void. (Where this is no coverage under this policy, there is NO duty to defend.) All other terms, conditions and warranties remaining unchanged SCHEDULE A Cont d. 5

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