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I understand that the Neuse River MST Self Guided Trip I am undertaking has a high level of risk that could result in the destruction or loss of personal property, personal injury, or even death. I agree that I am voluntarily undertaking this trip and that I have the skills, and am physically and mentally prepared for it. I agree to assume all risks associated with the Neuse River MST Self Guided Trip and will not hold Two Sisters Adventure Company, LLC, it’s employees or volunteers responsible for any issue that may arise.
 

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
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*

Confirm Email*
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Trip Prerequisites (Please check to acknowledge fulfillment of each)
I have researched the NCMST Trail Guide "Segments 11A-16A The Neuse River Paddle Route" *
I agree
I have familiarized myself with the hazards noted in the NCMST Trail Guide "Segments 11A-16A The Neuse River Paddle Route" *
I agree
I have familiarized myself with the USGS Gauge stations along the Neuse River *
I agree
I have packed the appropriate clothing, equipment, and food to complete this trip *
I agree
I will wear a properly fitted PFD the ENTIRE time I am on the water in my boat, and while I am getting in and out of my boat *
I agree
I will make regular check-ins through text, phone, or email *
I agree
I will check weather and water levels daily (at minimum) *
I agree
I will find and stay in a safe location in the case of severe weather or high water levels *
I agree
I have the skills and the ability to safely complete this trip *
I agree
I have received information on take out access points and emergency contact information for Two Sisters Adventure Company. I agree to contact Two Sisters if I have any change of plans for take out location or time. *
Yes
No
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*

Middle Name

Last Name*

Phone*
Parent or Guardian's 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.


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