Firefly Sync - Registration - Whitewater Center

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Name*

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Please bring an ID matching the name on this registration to be presented upon arrival.

Select The Event Date You Want To Attend*

Phone*

Email*

Number of people attending in your car*

Please enter a number from 1 to 10.

Address*

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Emergency Contact*

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Phone*

I have read and understand the Whitewater's Assumption or Risk, Release, and Indemnity Agreement.*

I understand

Assumption of Risk, Release, and Indemnity Agreement

The premises and activities operated by Whitewater are inherently dangerous and expose one to significant risk of bodily injury or death and property damage. You and the occupants of your vehicle are responsible for your own safety and property at all times. It is your responsibility to exercise caution and to be aware of your surroundings. You and all occupants of the vehicle assume all hazards and risks and accept responsibility for any property damage and loss, and for any personal injury encountered by you and the occupants of the vehicle.*

I understand

All vehicles remain in the control of the owner and Whitewater assumes no responsibility for the safety and protection of the vehicle or articles contained therein.*

I understand

Whitewater may take and use photographs, video, film, and other images of me and all vehicle occupants participating in or observing the activities. I waive any right of privacy, publicity, compensation, copyright, or other right of privacy, publicity, compensation, copyright, or other rights to those images and I consent to Whitewater using those images for any purpose.*

I understand

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Credit Card*

Card Details

Cardholder Name

Billing Address*

Same as address entered on previous page

Street Address City State ZIP Code

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Firefly Sync – Registration