REGISTRATION | Above The Water

RIDER REGISTRATION FORM

First Name

Family Name

Date of birth

Emergensy contact/Number

Language

Passport/ ID card

Adress

Flight info (flight number , date and arrival time at the airport)

Medical details

Injury

Specific diet requirements (vegetarian , allergies ...)

Phone

E-mail

I authorize the collection and use of the above personal information as is required for administrative purpose.

I understand that all my personal information is confidential and will not be released without my signed consent.

Kitesurfing and yoga are not recommended and are not safe under certain medical conditions. By signing, I affirm that a licensed physician has verified my good health and physical condition to participate in kitesurfing session offered by «Above the Water» and yoga classes-offered by «Leeloo Yoga». In addition, I will make my instructor aware of any medical conditions or physical limitations before class. If I am pregnant, become pregnant or I am post-natal or post-surgical, my signature verifies that I have my physician's approval to participate. I also affirm that I alone am responsible to decide whether to practice kitesurfing and yoga and participation is at my own risk. I hereby agree to irrevocably release and waive any claims that I have now or may have hereafter against «Above theWater» and «Leeloo Yoga».

Name

Signature

Date

DONE