Loading...

Waiver of Claims (collectively the “Waiver”) 

THIS AGREEMENT AFFECTS YOUR LEGAL RIGHTS, READ IT CAREFULLY 


Every customer of, or visitor to Upper Clements Cottages & RV Park must read and complete this Waiver before being on the premises and before participating in any Activities (as defined below). 

  1. Understanding: I understand that this Waiver is made for the benefit of Upper Clements Cottages & RV Park and each of its directors, officers, employees, volunteers, officials, lessees, and agents (collectively, the “Campground”). I am a Customer of the Campground regardless if I pay to participate in Activities of the Campground, am a guest at the Campground or if I am visiting the Campground (all the “Customer”). I acknowledge that if I am accompanied by a minor then I confirm that all statements made herein are being made on behalf of such minor and are complete and truthful.  
  2. Risks: I understand that there are inherent risks (“Risks”) associated with the use of the premises and the use of the premises’ facilities, and participation in sports, water sports, swimming, fitness, instruction, food & beverage services, and all other activities, services, programs or events provided or organized by the Campground (the “Activities”). 
  3. Watersports, Boating and Swimming: I freely accept and fully assume all responsibility and acknowledge that participating in water sports, water parks, boating and swimming involves known and unanticipated risks that could result in physical or emotional injury, paralysis, death or damage to myself, my children, property or third parties. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity. 
  4. Potential for Injury: I am aware that the Risks include the potential for serious personal injury, death, or property damage. I understand the Risks may be relative to my own state of fitness and health (including physical, mental and emotional), and to the awareness, care and skill with which I conduct myself. 
  5. Assumption of Risk: I freely accept and fully assume all responsibility for all Risks and possibilities of personal injury, death, property damage or other loss resulting from my participation in the Activities. I accept these Risks and agree to the terms of this Waiver, even if the Campground is found to be negligent or in breach of any duty of care or any obligation to me in any way in respect of the Activities. 
  6. Parental Supervision of Children: I acknowledge, represent and agree that it is the responsibility of parents or guardians to supervise children and ensure their safety during any and all activities and at all times while on the Campground premises. 
  7. Waiver of Claims and Release: In addition to consideration given to the Campground for my participation in Activities and for being on the Campground property, I and my heirs, next of kin, executors, administrators and assigns (collectively my “Legal Representatives”), agree: 
  8. a. to waive all claims that I have or may have in the future against the Campground; 
  9. b. to release and forever discharge the Campground from all liability for all personal injury, death, property damage or other loss resulting from my participation in Activities due to any cause, including but not limited to negligence (failure to use such care as a reasonably prudent and careful person would use under similar circumstances) either passive or active, breach of any duty imposed by law, breach of contract or mistake or error of judgement of the Campground; 
  10. c. to release and forever discharge the Campground from all liability for all personal injury, death, property damage or other loss resulting from any infectious disease, virus, bacterium or other microorganism (whether asymptomatic or not);  
  11. d. to release and forever discharge the Campground from all liability for all personal injury, death, property damage including any mutation or variation thereof;  
  12. e. to be liable for and to hold harmless and indemnify the Campground from all actions, proceedings, claims, damages, costs, demands including court costs and costs on a solicitor and client basis, and liabilities of whatsoever nature or kind arising out of or in any way connected with my, or my guests or any minor at the Campground with me participation in Activities. 
  13. Application: I agree that this Waiver shall remain in full force and effect for all visits by me to the Campground whenever they occur and that entry onto the Campground property is conditional upon agreeing to the terms of this Waiver. 
  14. Governing Law: I agree that this Waiver and all terms contained within are governed by the laws of the Province of Ontario. I hereby irrevocably submit to the exclusive jurisdiction of the courts of Ontario. Any litigation to enforce this Waiver must be instituted in the Province of Nova Scotia. 
  15. Confirmation: I confirm that I have had sufficient time to read and understand each term in this Waiver in its entirety, and have agreed to the terms freely and voluntarily. I understand that this Waiver is binding on myself and my Legal Representatives. I confirm that I have reached the age of majority in the Province of Nova Scotia. 

I have read and fully understand and agree to all the terms and conditions of this Waiver and I have explained the risks, dangers and hazards to members of my group listed on this form. 


I Agree
 Date: June 16, 2025 


ASSUMPTION OF RISK, RELEASE OF LIABILITY, WAIVER OF CLAIMS, and INDEMNITY AGREEMENT

(THE “WAIVER”)

BY SIGNING THE WAIVER, YOU WILL WAIVE CERTAIN LEGAL RIGHTS,

INCLUDING THE RIGHT TO SUE AND CLAIM COMPENSATION FOR INJURY

PLEASE READ CAREFULLY!

ONLY ONE RETREAT GUEST IS PERMITTED PER WAIVER

TO: Upper Clements Cottages LTD., and each of their directors, officers, employees, owners, volunteers, agents, successors, assigns, insurers, affiliates, contractors and subcontractors, suppliers, representatives, participants, and sponsors (collectively, the “UPPER CLEMENTS COTTAGES LTD”).

DEFINITIONS:

In the Waiver, the term “Facility” means the areas located in and surrounding 3059/3067 Hwy 1, Upper Clements, NS, including but not limited to its reception area, showers, washrooms, relaxation pools, hot tubs, cold plunge pools, saunas, steam rooms, treatment rooms, indoor and outdoor relaxation areas including fire pit areas, hammock areas swing areas and other equipment and apparatuses, eating areas, hallways, walkways, ramps, stairs, elevators, doorways and other access points, parking lots, driveways, sidewalks, lawns and other vegetation and landscapes.

In the Waiver, the words “use of the Facility” shall include all activities at the Facility, including but not limited to use of its reception area, showers, washrooms, relaxation pools, hot tubs, cold plunge pools, saunas, steam rooms, treatment rooms, indoor and outdoor relaxation areas including fire pit areas, hammock areas swing areas and other equipment and apparatuses, eating areas, hallways, walkways, ramps, stairs, elevators, doorways and other access points, parking lots, driveways, sidewalks, lawns and other vegetation and landscapes, and all other uses, events and other services involving or related in any way to the Retreat Facility, which are provided, arranged, organized, conducted, sponsored or authorized by Upper Clements Cottages LTD.

ASSUMPTION OF RISKS:

1. I am aware that my use of the Spa Facility involves many risks, dangers and hazards to myself and my property, which include, but are not limited to: Accidental drowning and injury from prolonged underwater exposure; ingestion of water; exposure to Spa Facility cleaning and maintenance chemicals; hypothermia; frost bite; burns from water, chemicals, and the sun; skin irritation; cuts, scrapes and bruises; nail and or nail bed injuries; open and closed head injuries including concussion; eye injuries; ear injuries; muscle and joint sprains and strains; broken bones, allergic reactions, including food allergies; food borne illness; alcohol poisoning; paralysis; death; wet and slippery floors, decks, ramps, stairs, equipment, other surfaces; falls from elevated surfaces and equipment in the Spa Facility; loss of balance; slipping; tripping; falling; impact or collision with other people, equipment and/or other objects or physical structures including but not limited to the bottom, sides or edges of the relaxation pools, hot tubs, saunas, steam rooms, treatment areas, fire pit areas, hammock areas, swing areas, eating areas, hallways, walkways and other furniture; exposure to dirt, algae, mold, bacterial, viral and fungal agents, and other pathogens; theft, loss of, or damage to, personal property; flying and floating objects; misuse or malfunctions of equipment, furniture or apparatus, horseplay and negligence of other Facility users, absence of any life guards or first aid personnel; and NEGLIGENCE ON THE PART OF THE RETREAT, INCLUDING THE FAILURE OF THE RETREAT TO TAKE REASONABLE STEPS TO SAFEGUARDOR PROTECT ME OR MY PROPERTY FROM THE RISKS, DANGERS AND HAZARDS OF USING THE FACILITY INCLUDING THOSE REFERRED TO ABOVE. I FREELY ACCEPT AND FULLY ASSUME ALL SUCH RISKS, DANGERS AND HAZARDS OF USE OF THE FACILITY INCLUDING THOSE REFERRED TO ABOVE. I FREELY ACCEPT AND FULLY ASSUME ALL SUCH RISKS, DANGERS ANDHAZARDS AND THE POSSIBLITY OF PERSONAL INJURY, DEATH, PROPERTY DAMAGE OR LOSS RESULTING THEREFROM OR RELATING IN ANY WAY TO MY USE OF THE SPA FACILITY.

2. I have been warned and understand that NO LIFE GUARDS OR FIRST AID PERSONNEL will be on duty or present during my use of the Spa Facility and I specifically acknowledge and accept that there is an increased risk of injury and death to me as a result of this. I elect to use the Spa Facility in spite of this increased risk and freely accept and assume all risks, dangers and hazards related to my use of the Facility with no life guards or first aid personnel on duty or present there at that time, including but not limited to those risks, dangers and hazards referred to above.

3. I have been warned and understand that THE RETREAT FACILITY employees have difficult jobs to perform. They seek to create a safe environment but may be unaware of a guest’s health or abilities. They may give incomplete warnings or instructions.

4. I understand and I have been warned and understand that the consumption of alcoholic beverages in conjunction with the use of the Retreat Facility can exacerbate the effects of alcohol and make me more prone to the risks, dangers and Hazards above. I confirm that I will NOT consume alcoholic beverages in the Retreat Facility and I will NOT become intoxicated at the Facility or prior to using the Facility.

RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY:

In consideration of UPPER CLEMENTS COTTAGES LTD permitting my use of the Facility, and for other good and valuable consideration, the sufficiency of which is acknowledged, I, ON BEHALF OF MYSELF, MY SPOUSE, MY CHILDREN, MYPARENTS, MY HEIRS, MY ASSIGNS, MY PERSONAL REPRESENTATIVES, AND MY ESTATE, AGREE AS FOLLOWS:

1. TO WAIVE ANY AND ALL CLAIMS that I have or may have in the future against UPPER CLEMENTS COTTAGES LTD and to release UPPER CLEMENTS COTTAGES LTD from any and all liability for any loss, damage, expense or injury, including death, that I may suffer or that my spouse, my children, my parents, my heirs, my assigns, my personal representatives or my estate may suffer as a result of my use of the Facility DUE TO ANY CAUSE WHATSOEVER, INCLUDING NEGLIGENCE,BREACH OF CONTRACT, BREACH OF STATUTE, BREACH OF REGULATION, BREACH OF ANY STATUTORY OR REGULATORY DUTY OF CARE AND/OR WARRANTY, INCLUDING ANY DUTY OF CAREOWED UNDER THE Occupiers’ Liability Act. 1996, c.27, s.1 BY UPPER CLEMENTS COTTAGES LTD, AND ALSO INCLUDING ANY FAILURE ON THE PART OF UPPER CLEMENTS COTTAGES LTD TO TAKE REASONABLE STEPS TO SAFEGUARD OR PROTECT ME FROM THE RISKS, DANGERS OR HAZARDS OF MY USE OF THE FACILITY INCLUDING THOSE REFERRED TO ABOVE.

2. To hold harmless and indemnify UPPER CLEMENTS COTTAGES LTD of and from any claims and liability, including all related legal fees and expenses, for any property damage, loss, personal injury or death to any third party, arising from or connected in any way with my use of the Facility.

3. That the Waiver and any rights, duties and obligations as between the parties to the Waiver shall be governed in accordance with the laws of the Province of Nova Scotia and no other jurisdiction.

4. That any litigation, actions, suits or claims brought by me, my spouse, my children, my parents, my heirs, my assigns, my personal representatives or my estate against UPPER CLEMENTS COTTAGES LTD arising or connected in any way to my use of Facility, shall be brought solely within the Province of Nova Scotia and shall be in the exclusive jurisdiction of the courts of the Province of Nova Scotia unless otherwise agreed to by the parties to the Waiver.

5. That if any portion of the Waiver is found to be void or unenforceable, the remaining portions shall remain in full force and effect.

6. That I grant UPPER CLEMENTS COTTAGES LTD the right to photograph, videotape and/or record me and to use my name, face, likeness, voice and appearance in connection with exhibitions, publicity, advertising and promotional materials without reservation, limitation or compensation.

7. That the Waiver shall be effective and binding upon my spouse, my children, my parents, my heirs, my assigns, my personal representatives or my estate in the event of my death or incapacity.

I CONFIRM that in entering into the Waiver, I am not relying on any oral or written statements made by UPPER CLEMENTS COTTAGES LTD, or the lack of any such representations or statements, with respect to the condition or safety of the Facility, or any related equipment or apparatus, other than what is set forth in the Waiver.

I CONFIRM that I have carefully read, considered and understand the contents of the Waiver, and agree to be bound by its terms and I FURTHER CONFIRM that I am relying wholly upon my judgment, belief and knowledge, freely and of my own accord, as acknowledged and confirmed by my digital signature hereon.


I Agree
Date: June 16, 2025

First Participant's Name
First Name*
Last Name*
First Participant's Date of Birth*
Date of Birth
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Last Name*
Phone*
Parent or Guardian's Date of Birth*
Date of Birth
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!