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CENTRAL COAST KAYAKS
1879 SHELL BEACH RD. SHELL BEACH, CA 93449
(805) 773-3500

Liability Release, Assumptions of Risk, and Indemnity Agreement

Today's Date: December 4, 2024

In consideration of Central Coast Kayaks services and/or equipment for me to participate in outdoor activities, programs, expeditions, and/or courses planned or supervised by Central Coast Kayaks I agree as follows: 

I understand that outdoor activities have inherent risks, dangers, and hazards and such exists in my use of Central Coast Kayaks equipment and my participation in outdoor activities, programs, expeditions, and/or courses planned or supervised by Central Coast Kayaks. AND I understand that certain skills, abilities, and physical and mental health are required in order to reduce the dangers involved in kayaking; I confirm that I possess such skills, abilities, and health required to participate in such activities.

I understand that my participation in such activities and/or use of such equipment may result in illness or injury including but not limited to bodily injury, disease, fractures, strains, partial and/or total paralysis, death or other ailments that could cause serious disability.

I understand that these risks and dangers may be caused by the negligence of the owners, employees, officers, or agents of Central Coast Kayaks; the negligence of the participant, the negligence of others, accidents, breaches of contract, the forces of nature, or other causes. Central Coast Kayaks personnel have difficult jobs to perform. They seek safety but are not infallible. They might be unaware of a participant’s fitness or abilities. Risks or dangers may arise from foreseeable or unforeseeable causes including, but not limited to, guide/instructor decision-making including that they may misjudge terrain, weather, trail, sea conditions, surf or tides, and currents, risks of falling out of or drowning while in a kayak and such other risks, hazards, and dangers, that are integral to recreational activities that take place in a wilderness, outdoor, marine, or recreational environment.

I understand that my participation in these activities and use of the equipment I hereby assume all risks and dangers and all responsibility for any losses and/or damages whether caused in whole or in part by the negligence or other conduct of the owners, agents, officers, or employees of Central Coast Kayaks, or by any other person

I, on behalf of myself, my personal representatives, and my heirs hereby voluntarily agree to release, waive, discharge, hold harmless; defend and indemnify Central Coast Kayaks, the city of Pismo Beach, Grover Beach, San Luis Harbor District, and the County of San Luis Obispo, and its owners, agents, officers, and employees from any claims, actions, or losses for bodily injury, property damage, wrongful death, loss of services, or otherwise, which may arise from Central Coast Kayaks equipment or my participation in kayaking activities. I specifically understand that I am releasing, discharging, and waiving any claims or actions that I may have presently or in the future for the negligent acts or other conduct by the owners, agents, officers, or employees of Central Coast Kayaks. 

Any controversy arising out of or pertaining to this agreement, or its scope, interpretation, application, enforcement, or alleged breach, shall be resolved through binding arbitration administrated through an arbitration provider in San Luis Obispo County unless otherwise agreed upon. Each side shall bear the expense of the arbitration proceeding equally unless otherwise agreed upon. The arbitration proceedings shall be governed by California Code of Civil Procedure 1280 et seq. in effect at the time of arbitration or any other rules the parties mutually agree upon in writing. Any award of the Arbitrator(s) may be entered as a judgment in any court having jurisdiction.

Furthermore, I do authorize Central Coast Kayaks, to photograph, televise, videotape, or by any other means record the image or voice of the participant while engaged in any activity planned or promoted by Central Coast Kayaks, and to use such records for instructional, promotional, or commercial use. Any reproduction for commercial use by anyone other than Central Coast Kayaks is prohibited.

I HAVE READ THE ABOVE WAIVER AND RELEASE. BY SIGNING IT I AGREE TO EXEMPT AND RELIEVE CENTRAL COAST KAYAKS FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE, OR WONDERFUL DEATH CAUSED BY NEGLIGENCE OR ANY OTHER CAUSE.






Please select who will be participating...
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First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information
Click to customize drop-down*

Tour/Class Date *
Do you get seasick?*
No
Yes

If yes, did you/will you take motion sickness medication before your tour/class?
Can you swim?*
No
Yes
If yes, please rate your swimming ability:
Are you allergic to any of the following? (Check if "yes")
Medication
Food
Insects

Other allergies (please list)

If yes to any of the above, please describe your allergic reaction and how you treat it:
Do you have a history of any of the following?
Abnormal Blood Pressure
Arthritis
Asthma
Diabetes
Dizziness
Hearing Loss
Joint Pain
Migraines
Mobility Issues
Poor Circulation
Poor Eyesight
Seizures
Stomach Problems
Unconsciousness

Other:

If yes to any of the above, have you been treated?

Are you currently taking any medications that you feel we should be aware of? If yes, please list.

Please make sure you have any necessary medical items (i.e. EpiPen) with you!

First Participant's Signature*
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
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*
Parent or Guardian's Information
Click to customize drop-down*

Tour/Class Date *
Do you get seasick?*
No
Yes

If yes, did you/will you take motion sickness medication before your tour/class?
Can you swim?*
No
Yes
If yes, please rate your swimming ability:
Are you allergic to any of the following? (Check if "yes")
Medication
Food
Insects

Other allergies (please list)

If yes to any of the above, please describe your allergic reaction and how you treat it:
Do you have a history of any of the following?
Abnormal Blood Pressure
Arthritis
Asthma
Diabetes
Dizziness
Hearing Loss
Joint Pain
Migraines
Mobility Issues
Poor Circulation
Poor Eyesight
Seizures
Stomach Problems
Unconsciousness

Other:

If yes to any of the above, have you been treated?

Are you currently taking any medications that you feel we should be aware of? If yes, please list.

Please make sure you have any necessary medical items (i.e. EpiPen) with you!

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.


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