|This is a printable version. Please print form, sign and send in with your deposit.|
|Release and Acknowledgment of Risk
In consideration of the services of THE SEA KAYAKER, its owners, agents, officers volunteers participants, employees, and all other persons or entities acting on its behalf ( hereinafter collectively referred to as TSK), I hereby agree to release and discharge TSK, on behalf of myself, my parent, my heirs, assigns, personal representatives and estate as follows:
1. I acknowledge that sea kayaking, kayak touring, kayak instruction, instruction involving the use of the roll cage, canoeing, camping, hiking and other adventure activities,including traveling into remote areas entails known and unanticipated risks which could result in severe physical or emotional injury, paralysis, death, or damage to myself, to property, or to third parties. I understand that such risks simply cannot be eliminated without compromising the essential qualities of the activity.
These risks include, but are not limited to: capsize, collision with objects or other water craft, exposure to turbulent water, rain and cold, contact with poisonous or injurious plants, venomous and / or aggressive animals, and illness in remote areas where definitive medical care might be delayed. These and other unforeseen risks could result in severe injury or death from hypothermia, accidental drowning, or trauma to skeletal, muscular, nervous, circulatory, respiratory and lymphatic systems. Furthermore, TSK guides and instructors have difficult jobs to perform. They seek safety, but are not infallible. They might be ignorant of a participant’s fitness or abilities. They might misjudge the weather, the elements or the terrain. They may give inadequate warnings or instructions, and the equipment being used might malfunction.
2. I expressly agree to accept and assume all of the risks existing in this activity. My participation in the activity is purely voluntary, and I elect to participate in spite of the risks.
3. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless TSK from any and all claims, demands, or causes of action, which are in any way connected with my participation in this activity or my use of TSK’s equipment or facilities, including any such claims which allege negligent acts or omissions of TSK.
4. I certify that I have insurance to cover any injury or damage I might cause or suffer while participating in this activity, or else I agree to bear the costs of such injury or damage myself.
5. I certify that I have no medical or physical conditions which could interfere with my safety in this activity or else I am willing to assume, and bear the cost of, all risks that may be related, directly or indirectly, by any such condition.
6. I certify that I am not under the care of a practicing physician or doctor for the treatment of a disease or illness which is physical or mental and for which may interfere or cause further harm to myself while participating in sea kayak instruction or while on a guided tour lead by The Sea Kayaker.
7. I certify that I have spoken to all of my practicing physicians and doctors under which I have been giving prior medical care and treatment and stating to them my desire to undertake the sport of sea kayaking and have been cleared by each doctor or physician to continue with the sport.
8. I certify that I am not under the influence of alcohol or medications that may interfere with my judgment or narcotics and will not partake of any alcohol or medications that may interfere with my judgment or narcotics while participating in this activity.
9. I further understand that any agents, owners, officers, employees or volunteers of TSK reserve the right to dismiss me from any activity and/or cancel my reservation for any activity, with out a refund for my deposit or final payment, if the presence of alcohol, mind altering medication or narcotics is found or detected.
10. In the event that I file a lawsuit against TSK, I agree to do so solely in the State of Georgia, and agree that the substantive laws of that state shall apply in that action. I agree to indemnify and hold TSK harmless for all cost and attorney’s fees incurred to enforce this agreement.
In addition I understand that while participating in any TSK event I may be photographed and/or video taped. I understand and agree that the photograph(s) and/or video may be used at anytime by TSK in all forms of media including but not limited to print, video, broadcast, internet use world wide. By signing this waver I authorize any initial and any subsequent disclosure or publication of the photograph(s) and/or video at any time.
I have had sufficient opportunity to read this entire document. I have read and understood it and agree to be bound by its terms. PLEASE PRINT LEGIBLY.
Signature ______________________________________________ Date _____________________
Print Name ____________________________________________ Phone ______________________
City, State, Zip _________________________________________________________________________
Emergency Contact ( Name & Phone ) _______________________________________________________
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If you are taking medication please list them on the back of the form. Also, please tell us where the medication is located in your gear if in an emergency and you can not speak.