MI Paddle Stewards - Alpena

Registrant Information

* First Name

* Last Name

Pronouns   Fae/Faer/Faers  E/Ey/Em/Eir/Eirs  He/Him/His  Per/Pers  She/Her/Hers  They/Them/Their/Theirs  Ve/Ver/Vis  Xe/Xem/Xyr/Xyrs  Ze/Zie/hir/hirs  My pronoun is not represented above 

* Phone Number

* E-mail If you supply an e-mail address, a receipt for your registration will automatically be sent to that account. An e-mail address is required to pay using a credit card.

* County Alcona Alger Allegan Alpena Antrim Arenac Baraga Barry Bay Benzie Berrien Branch Calhoun Cass Charlevoix Cheboygan Chippewa Clare Clinton Crawford Delta Dickinson Eaton Emmet Genesee Gladwin Gogebic Grand Traverse Gratiot Hillsdale Houghton Huron Ingham Ionia Iosco Iron Isabella Jackson Kalamazoo Kalkaska Kent Keweenaw Lake Lapeer Leelanau Lenawee Livingston Luce Mackinac Macomb Manistee Marquette Mason Mecosta Menominee Midland Missaukee Monroe Montcalm Montmorency Muskegon Newaygo Oakland Oceana Ogemaw Ontonagon Osceola Oscoda Otsego Ottawa Presque Isle Roscommon Saginaw Sanilac Schoolcraft Shiawassee St. Clair St. Joseph Tuscola Van Buren Washtenaw Wayne Wexford Not Applicable

Event Information

* How often do you typically kayak in a year?   1-5 times  6-10 times  11+ times 

Have you participated in any kayak safety training or kayak skills training? *

Yes No

For example: American Canoe Association instructor-led course

If you answered yes above, please provide information on the skills or safety training you completed.

How familiar are you with aquatic invasive species identification? *

No experience Some experience - can identify 2-3 species Extensive experience - can identify more than 5 species

How familiar are you with native species identification? *

No experience Some experience - can identify 2-3 species Extensive experience - can identify more than 5 species

* Who do you anticipate teaching using the content from this course?:

* What are you most interested in learning about in this course?:

Kayak Information

Please indicate whether *

I have a kayak I can bring to the training I would need to rent a kayak to participate in the training

Photo/Audio/Video Release

I authorize Michigan State University to record my image and voice (or that of my minor child named here) and give Michigan State University and all persons or entities acting pursuant to MSU's permission or authority, all rights to use these recorded images. I understand that said images will be used for educational, advertising and promotional purposes in all conventional and electronic media, and any future media. I also authorize the use of any printed material in connection therewith. I understand and agree that these images and recordings may be duplicated, distributed with or without charge, and/or altered in any form or manner without future/further compensation or liability, in perpetuity.

* Please Indicate your authorization   Yes  No 

MICHIGAN STATE UNIVERSITY - MI Paddle Stewards

ASSUMPTION OF RISK, WAIVER AND RELEASE OF LIABILITY AGREEMENT

1. ASSUMPTION OF RISK. You understand and acknowledge that MI Paddle Stewards involves risk, including but not limited to, risk of death, serious bodily injury, and property damage. These risks may result from the program itself, from the acts of others, or from the unavailability of emergency medical care. You acknowledge and agree that you are voluntarily assuming all the risks that may arise out of your participation in MI Paddle Stewards. You acknowledge that participation in MI Paddle Stewards is voluntary and you may withdraw at any time.
2. INSTRUCTIONS, POLICIES, AND PROCEDURES. At all times during participation in MI Paddle Stewards, you agree to fully observe and implement all instruction provided by any employee or representative of MSU with respect to safety procedures and with respect to your conduct and actions while participating in MI Paddle Stewards. MSU staff and representatives reserve the right to revoke your permission to participate in MI Paddle Stewards and request that you to leave immediately for any violations of the rules of MSU, including rules related to your conduct during MI Paddle Stewards.
3. SUPERVISION OF MINORS. You understand that minors are required to be supervised by a parent, guardian, or other adult at all times.
4. WAIVER AND RELEASE. To the fullest extent permitted by law, you hereby release, waive, and discharge Michigan State University, its Board of Trustees, officers, employees, agents, students, or volunteers from any and all claims, actions, causes of action, suits, liability, losses, demands, damages, expenses, fees, and costs for any property damage, property loss or theft, personal injury, death or other loss arising from or relating to your participation in MI Paddle Stewards. You release and discharge Michigan State University from any claim that arises or may arise due to any first aid, medical treatment, or service rendered to you.
5. CHOICE OF LAW; JURISDICTION. This agreement shall be governed in all respects by the laws of the State of Michigan. The Michigan Court of Claims or Federal District Court for the Western District of Michigan will hear any action arising out of this agreement, and you consent to jurisdiction in the State of Michigan.   
6. You expressly agree that the foregoing agreement is intended to be as broad and inclusive as permitted by Michigan law and that if any portion thereof is held to be invalid, the remainder of the agreement shall continue in full legal force and effect.

You acknowledge that you have read the foregoing and that you are aware of the legal consequences of this agreement, including that it releases Michigan State University from claims you may have if you are injured or your property is damaged as a result of your participation in MI Paddle Stewards.

* I acknowledge that I have read the foregoing and accept the agreement above.

* Please type your name below to confirm your acknowledgement of risk and limiated release of liability

Register

I would like to register for *

MI Paddle Stewards Training (17 openings available) Safety Kayak Skills Training (10 openings available) Both Trainings (full day)