Loading...

Assumption And Acknowledgment Of Risks And Release Of Liability Agreement For Wailua Kayak Adventures

In consideration of being allowed to participate in watersport events and activites and/or being provided with watersport Recreational property or services, for myself and any minor children for whom i am parent, legal guardian or otherwise responsible, and for my/our heirs, personal or assigns:

1. ACKNOWLEDGEMENT OF RISKS:  Acknowledgement that some, but not all, of risks of participating in the watersport activity include: (1) Changing water flow, tides, currents, wave action and ship wakes: (2) Collison with any of the following: other participants, their watercraft, watercrafts, and manmade or natural objects: (3) Wind shear, inclement weather, lightning, variances and extremes of wind, weather and temperatures: (4) My sense of balance, physical coordination, ability to operate equipment, swim, and/or follow directions: (5) Collison, capsizing, sinking or other hazard which results in wetness, injury, exposure to the elements, hypothermia, and/or drowning: (6) the presense of insects and marine life forms: (7) Equipment failure or operator error: (8) Heat or sun related injuries or illness, including sunburn, sunstroke or dehydration: (9) Fatigue, chill and/or dizziness which may diminish my/our reaction time and increase the risk of accident. (

2.EXPRESS ASSUMPTION OF RISK AND RESPONSIBILITY:  Agree to assume the responsibility for all the risks of the activity, whether identified above or not, (EVEN THOSE RISKS ARISING OUT OF THE NEGLIGENCE OF THE RELEASEES NAMED BELOW). My/our participation in the activity is purely voluntary. I assume full responsibility for my vehicle and the loading of water equipment onto the vehicle and any damage that may occur. I assume full responsibility for myself and any minor children for whom i am responsible for any bodily injury, accident, illness, paralysis, death, loss of personal property and expenses thereof as a result of any accident which may occur while we participate in the activty (EVEN IF CAUSED, IN WHOLE OR IN PARTY BY THE NEGLIGENCE OF THE REALEASE NAMED BELOW).

I agree to wear a U.S. Coast Guard approved personal floatation device (life jacket) while participating in the activity or riding in any watercraft.

3. RELEASE: I hearby release WAILUA KAYAK ADVENTURES (name of the lessor) its principals, and hold harmless directors, officers, agents, employees and volunteers, their insurers and each and every land owner, municipal and/or governmental agency upon whose property an activity is conducted ("owner") and their insurers, if any, (Collectively "releases") FROM AND ALL LIABILTY OF ANY NATURE FOR ANY AND ALL INJURY OR DAMAGE (INCLUDING DEATH) TO ME OR MY MINOR CHILDREN AND OTHER PERSONS AS A RESULT OF MY/OUR PARTICIPATION IN THE ACTIVITY, EVEN IF CAUSED BY THE NEGLIGENCE OF ANY OF THE RELEASEES NAMED ABOVE OR ANY OTHER PERSONS (INCLUDING MYSELF).  I/WE UNDERSTAND AND AGREE THAT THIS RELEASE INCLUDES CLAIMS BASED ON THE ACTIONS, OMMISIONS, OR NEGLEGENCE OF WAILUA KAYAK ADVENTURES, ITS EMPLOYEES, AGENTS, AND REPRESEVTEVES, WHETHER A COVID-19 INFECTION OCCURS BEFORE, DURING OR AFTER ATTENDING AND ACTIVITY WITH WAILUA KAYAK ADVENTURES.

I'VE/WE'VE READ THIS ASSUMPTION AND ACKNOWLEDGEMENT OF RISKS AND RELEASE OF LIABILITY AGREEMENT. I UNDERSTAND THAT BY SIGNING THIS DOCUMENT, I AM WAVING VALUABLE LEGAL RIGHTS, INCLUDING ANY AND ALL RIGHTS I MAY HAVE AGAINST THE OWNER, THE OPERATOR NAMED ABOVE, OR ITS EMPLOYEES, AGENTS SERVANTS OR ASSIGNS.

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Emergency Contact

Emergency Contact Name and Phone Number *
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Emergency Contact

Emergency Contact Name and Phone Number *
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Emergency Contact

Emergency Contact Name and Phone Number *
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Emergency Contact

Emergency Contact Name and Phone Number *
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Emergency Contact

Emergency Contact Name and Phone Number *
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Emergency Contact

Emergency Contact Name and Phone Number *
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Emergency Contact

Emergency Contact Name and Phone Number *
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Emergency Contact

Emergency Contact Name and Phone Number *
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Emergency Contact

Emergency Contact Name and Phone Number *
Tenth Participant's Name

First Name*

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

Emergency Contact Name and Phone Number *
Parent or Guardian's Email Address

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*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Emergency Contact

Emergency Contact Name and Phone Number *
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!