River Waiver
WATER PARTICIPANT RELEASE OF LIABILITY AND ASSUMPTION OF RISK
AGREEMENT
GREAT
RIVER OUTFITTERS LLC
***READ BEFORE SIGNING***
Participant Name: First ____________________________
Last: ___________________________________
Print Name
Participant’s Signature:
_____________________________________ Age ___________ Date: __________
Address:
______________________________City:
_______________
State: __________ Zip:
___________
Home
Phone: ________________________________ Cell Phone:
__________________________________
PARENTS/GUARDIANS OF PARTICIPANT OF MINOR AGE
(UNDER AGE 18 AT TIME OF REGISTRATION)
This is to certify that I, as parent/guardian with
legal responsibility for this participant, do consent and agree to his/her
release as provided above of all the Releasees, and, for myself, my heirs,
assigns, and next of kin, I release and agree to indemnify and hold harmless
the Releasees from any and all liability incidents to my minor child’s
involvement or participation in these programs as provided above, EVEN IF
ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted
by law.
___________________________________________________________ ____________ ______________
Parent/Guardian
Signature Age Date
In consideration of being allowed to participate in
any way in Great River
Outfitters, LLC activities,
operations, services, related events, and the use of Great River Outfitters, LLC equipment, I the undersigned,
acknowledge, appreciate, and agree that:
1. The
risk of injury from the activities involved in this program is significant,
including the potential for permanent paralysis and death.
2. I
KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN
IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full
responsibility for my participation.
3. I
willingly agree to comply with terms and conditions for participation. If I
observe any unusual significant hazard during my presence or participation, I
will remove myself from participation and bring such to the attention of the
nearest official immediately.
4. I,
for myself and on behalf of my heirs, assigns, personal representatives and
next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS Great River
Outfitters, LLC Vermont, its officers, officials,
agents and/or employees, other participants, sponsors,
advertisers, and, if applicable, owners and lessors of premises used to conduct
the event (RELEASEES), from any and all claims, demands, losses, and liability
arising out of or related to any INJURY, DISABILITY OR DEATH I may
suffer, or loss or damage to person or property, WHETHER ARISING FROM THE
NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted
by law.
5. I HAVE READ
THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND
ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT,
AND SIGN IT REELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
Great
River Outfitters, LLC
36 Park Road
Windsor,
Vermont
05089
GreatRiverOutfitters.com 802-674-9933
