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47050 Generals Hwy Unit 10
​Three Rivers, CA 93271

www.sequoiaparksconservancy.org

  1. I am aware that the courses or activities that I am participating in include certain risks including but not limited to bodily injury, death, illness, loss or damage to personal property and other safety-related dangers.
  2. I understand that the unique character of the program includes certain risks that cannot be eliminated.
  3. I assume responsibility for my own safety and loss or damage to personal property.
  4. I understand that I am responsible for providing my own personal health and accident insurance. The Sequoia Parks Conservancy (hereinafter SPC) has provided me with information pertaining to the risks involved, and I am voluntarily participating in these activities.
  5. I acknowledge other dangers not mentioned may exist, and I release and hold harmless SPC, its employees, staff, board of directors, members, instructors, volunteers, their representatives, and the National Park Service from any and all claims as a result of my participation in these activities.
  6. I understand instructors may be required to make decisions under difficult circumstances, and I give permission for instructors, staff, and emergency personnel to make necessary first aid decisions in the event of accident, injury, or illness.
  7. I understand activities may involve remote locations where communication and transportation are difficult, and I understand instructors may not possess the required training or equipment to handle incidents that may occur. In the case of injury, accident, illness, or inability to complete these activities, I will bear the full cost of any additional transportation or evacuation procedures performed by the SPC, the National Park Service or other personnel and equipment.
  8. I agree to reimburse SPC for any damage to their equipment if I fail to take reasonable care of the equipment placed in my care.
  9. I understand the registration cancellation policy and that I will not be reimbursed if I fail to complete a course or activity.
  10. I understand SPC reserves the right to cancel or change activities without prior notice and reserves the right to cancel the registration of any participant it determines fails to meet the requirements for these activities. My participation in this program or activity is purely voluntary. I agree to allow SPC the use of my name and likeness from photograph, digital image, or video taken during these activities to promote SPC activities or to create a sales item.
  11. I agree to allow SPC to use any written materials, testimonials, artwork, video, or photographs I produce as part of the activity/program that I submit to SPC to promote SPC activities or to create sales items, and I consent to and authorize such use without restrictions. I understand the physical requirements of participation in these activities and affirm I meet these requirements.

April 28, 2024

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

Phone*
Tenth Participant's Date of Birth*
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*
Let's stay in touch! We'd love to share more adventures with you!
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 Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
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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