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ZIP LINE ACTIVITIES RELEASE OF LIABILITY,
WAIVER OF CLAIMS, EXPRESS ASSUMPTION OF RISK
AND INDEMNITY ZIP LINE ACTIVITIES AGREEMENT
(the Zip Line Activities Agreement)

Please read this Zip Line Activities Agreement carefully and be certain that you understand the implications of signing. Note that the Zip Line Activities Agreement can be signed online (click on the online link) or can be filled out at one of our stations in our facility. The Zip Line Activities Agreement is valid for one (1) year after signing. At the end of the year, you must execute a new Zip Line Activities Agreement, provide a new photograph, and update your profile.

Express Assumption of Risk Associated with Zip Line Zip Line Activities

By signing below, I hereby understand, affirm and acknowledge that the hazards and risks of physical exertion associated with participating in all zip line activities (collectively, the Zip Line Activities) offered by G and V Business Ventures, LLC d/b/a Xtreme Park Adventures (Xtreme Park Adventures) and the rental and/or use of equipment and/or transportation associated therewith include, but are not limited to, the following:

  • Falls.
  • Contact with other participants and/or fixed or moving objects.
  • Risk of injury from the Zip Line Zip Line Activities or equipment utilized is significant, including but not limited to bodily injury, disease, strains, sprains, fractures, partial and/or total paralysis, eye injury, blindness, heat stroke, heart attack, Acts of God, permanent disability, and death.
  • Possible equipment failure and/or malfunction of my own or others equipment.
  • Risks associated with exposure to elements, excessive heat, hypothermia, impact of body upon water, injection of water into my bodily orifices, encountering either natural or man-made hazards, falling tree limbs, exposure to animals with the potential for kicking, biting, and/or moving in an unanticipated manner, causing injury and/or death.
  • My own negligence and/or the negligence of others, including but not limited to operator error and guide decision making including misjudging terrain, weather, trails or route direction.
  • Attack by or encountering insects, birds, and/or animals.
  • Accidents or illness occurring in remote places where there are no available medical facilities. I understand there are no trained medical personnel on staff and beyond basic first aid I authorize that medical attention will be sought immediately.
  • Fatigue, chill and/or dizziness, which may diminish my reaction time and increase the risk of accident.
  • Psychological trauma, including but not limited to panic caused by fear of heights.
  • Risk of delayed or no medical treatment due to accidents or illness occurring in remote places where there are no available medical facilities. I understand there are no trained medical personnel on staff with Xtreme Park Adventures. However, I authorize Xtreme Park Adventures to provide basic first aid and to seek medical attention, including calling 911.

I understand and acknowledge that the description of the risks above are not complete and that participation in the Zip Line Activities may involve additional unknown or unanticipated risks that are not readily foreseeable at this time, but which could result in serious injury, illness or death. In spite of such risks, I hereby assume with full knowledge all risks to me involved in participating in the Zip Line Activities and take all responsibility for all liabilities, losses, costs, and damages I incur as a result of my participation in such Zip Line Activities.

Release of Liability and Indemnity

In consideration for being permitted by Xtreme Park Adventures to participate in the Zip Line Activities on its property (the Premises), I HEREBY RELEASE, COVENANT NOT TO SUE AND AGREE TO INDEMNIFY AND HOLD G AND V BUSINESS VENTURES, LLC D/B/A XTREME PARK ADVENTURES AND ITS MEMBERS, MANAGERS, OFFICERS, EMPLOYEES, REPRESENTATIVES, LESSORS, AGENTS AND VOLUNTEERS (COLLECTIVELY, THE RELEASED PARTIES) HARMLESS FROM ANY AND ALL LIABILITIES, CLAIMS OR CAUSES OF ACTIONS I, MY ESTATE, HEIRS, SURVIVORS, EXECUTORS, OR ASSIGNS MAY HAVE FOR ANY INJURY, DAMAGE OR WRONGFUL DEATH ARISING FROM MY PARTICIPATION IN THE ZIP LINE ACTIVITIES WHETHER CAUSED BY MY NEGLIGENCE OR NEGLIGENCE OF THE RELEASED PARTIES OR OTHERWISE.

  • By executing this Zip Line Activities Agreement, I agree to hold the Released Parties harmless and indemnify them in conjunction with any injury, disability, death, or loss or damage to person or property that may occur as a result of engaging in the Zip Line Activities.
  • By entering into this Zip Line Activities Agreement, I am not relying on any oral or written representation or statements made by the Released Parties other than what is set forth in this Zip Line Activities Agreement.
  • I authorize anyone working for the Released Parties to call for such medical care for me, or to transport me to the appropriate clinic or hospital, if in the opinion of anyone working at the Premises, medical attention is needed for me. This authorizes a licensed health care provider or other first-aid provider to carry out emergency medical care deemed necessary for me in an emergency where normal permission is unavailable. I agree that upon transporting me to any medical facility, clinic, or hospital, that the responsibility of the Released Parties shall be complete and the Released Parties shall not have any further responsibility for me. I agree to pay all costs associated with such medical care and related transportation for me, and I hereby indemnify and hold the Released Parties harmless from any costs incurred by them in connection therewith.
  • I release any and all photos taken on the Premises to be the sole property of Released Parties and consent to the use of such photos for promotional and marketing purposes at the sole discretion of the Released Parties.
  • This Zip Line Activities Agreement shall be binding to the fullest extent permitted by law. If any provision of this Zip Line Activities Agreement is found to be unenforceable, the remaining terms shall be enforceable.
  • This Zip Line Activities Agreement shall be governed by the laws of the State of North Carolina, without regard to any applicable conflicts of law principles.

Photo/Video Release

I authorize the use of my appearance by XPA. I understand that I am to receive no compensation for any appearance. XPA shall have complete ownership of the media capture. I authorize XPA to use photo, video and voice. I authroize XPA to make copies of the photographs and recordings for the purposes of education, promotion or advertising. I further understand that the master copies are the property of XPA. I understand that i will inform XPA in advance if I choose not to be part of any photo or video taken. 

Medical Conditions and Declaration of Fitness

The Zip Line Activities are designed for participants of average mobility and strength who are in reasonably good health. Participants must be reasonably physically fit and able to control the speed of their travel along the zip line by grasping the cable above their head with leather gloves. Participants may also be required to pull themselves along a stretch of cable if they lose momentum before reaching any given landing platform. Additionally, participants must be able to climb a tower prior to beginning Zip Line Activities. Obesity, high blood pressure, cardiac and coronary artery disease, pulmonary problems, pregnancy, arthritis, tendonitis or other joint and muscular-skeletal problems may impair the safety and well-being of participants on the course, as may other medical, physical, psychological and psychiatric problems. All such conditions may increase the inherent risks of the experience and cause participants to be a danger to themselves or others. Participants with underlying medical problems that put them at greater risk of injury or illness during Zip Line Activities must carefully consider those risks before choosing to participate and they must fully inform tour staff in writing prior to the beginning of the tour. Xtreme Park Adventures reserves the right to exclude any applicant from participation for medical, safety or other reasons, in its sole, absolute and unlimited discretion.

I have read the foregoing statement of medical risks. I hereby declare that I am physically fit. I do not, and have not, suffered from any medical conditions, mental or physical, which could reasonably and foreseeably cause a dangerous situation to other persons or myself while participating in the Zip Line Activities offered by the Released Parties.

I HAVE READ THIS ZIP LINE ACTIVITIES AGREEMENT, I FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP LEGAL RIGHTS BY SIGNING IT, AND I SIGN FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

July 16, 2019

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
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*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Address

City *

State *
As the Parent, Guardian, or Temporary Guardian with legal responsibility for this participant, I understand the nature of the Zip Line Activities and the minor’s experience and capabilities and believe the minor to be qualified to participate in such Zip Line Activities with the capability of following the terms and conditions of this Zip Line Activities Agreement. Further, on behalf of myself and the participating minor, I hereby release, covenant not to sue and agree to indemnify and hold the released parties harmless from any and all liabilities, claims or causes of actions for any injury, damage or wrongful death arising from the minor’s participation in the Zip Line Activities whether caused by his/her negligence or negligence of the released parties or otherwise. Parents or guardians must fill in the PARENT/GUARDIAN portion completely for the minor to be able to participate in any of the Zip Line Activities.
Parent or Guardian's Name

First 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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