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Pinelands Adventures Services
Acknowledgement of Risk and Assumption of Personal Responsibility for Participation

TODAY'S DATE: April 19, 2024

Canoeing, kayaking, hiking or participating in a tour in the Pine Barrens are fun and rewarding activities which also include inherent hazards that may differ from the hazards we all routinely accept at home, in town or in the suburbs. With this in mind, we require that all those using Pinelands Adventures’ (hereinafter “Pinelands Adventures”) livery services or rental services and/or participating in any Pinelands Adventures activity, hike or tour (hereafter known as Pinelands Adventures Services) carefully review the below statements and sign this acknowledgement of risk and assumption of personal responsibility:

I understand that during my use of Pinelands Adventures Services, including among other activities transportation to and from launch and landing sites, hiking and tour locations and canoeing or kayaking on a stream or lake, I may be exposed to risks such as inclement weather, insects, terrain, water and other risks that are to be expected on field trips and in outdoors and/or wilderness activities.

I understand that it is impossible for Pinelands Adventures to guarantee my safety during this activity. I understand that I am responsible for my safety during this activity, and I assume that responsibility. I accept responsibility to verify with my physician that I have no physical or psychological problems that would prohibit my participation in this activity, and I accept responsibility for conditioning myself to be reasonably prepared for the activities I undertake. I understand that Pinelands Adventures cannot provide medicine or medical care to me and that I am responsible for anticipating and handling any medical conditions that may arise during such activities. I accept full responsibility for any costs incurred by Pinelands Adventures due to any such condition, illness or medication. I understand that possessing or consuming alcohol and/or intoxicating drugs is not permitted while utilizing any Pinelands Adventures Services. I agree that at no point will I be under the influence of alcohol or intoxicating drugs while participating in Pinelands Adventures Services.

I understand that my photo may be taken while participating in any Pinelands Adventures Services, and I grant permission to Pinelands Adventures to post photos of myself and my minor children on the Pinelands Adventures website and social media pages for the purpose of advertising and promoting Pinelands Adventures. All participants forever release and hold harmless Pinelands Adventures and its employees from any liability arising out of the use of these images.

Specifically, I, on behalf of myself, my family, successors and assigns, hereby voluntarily release, waive, hold harmless, defend and indemnify Pinelands Adventures and its employees, owners, officers and agents, from any and all claims, actions, or losses for bodily injury, property damage, wrongful death, loss of services or otherwise, whether or not caused by their negligence or gross negligence, that may arise out of my participation in activities related to the livery and/or rental services of Pinelands Adventures.

First Participant's Name

First Name*

Last Name*
First Participant's Date of Birth*
First Participant's Information

Date of Trip: *
First Participant's Signature*
Second Participant's Name

First Name*

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

Date of Trip: *
Third Participant's Name

First Name*

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

Date of Trip: *
Fourth Participant's Name

First Name*

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

Date of Trip: *
Fifth Participant's Name

First Name*

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

Date of Trip: *
Sixth Participant's Name

First Name*

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

Date of Trip: *
Seventh Participant's Name

First Name*

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

Date of Trip: *
Eighth Participant's Name

First Name*

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

Date of Trip: *
Ninth Participant's Name

First Name*

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

Date of Trip: *
Tenth Participant's Name

First Name*

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

Date of Trip: *
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*
Check to receive information, news, and discounts by e-mail.
A signed copy of this waiver will be sent to the email address you provide.
Minimum Age Requirement: 6 (six) years old
Due to insurance regulations all minor participants must be at least 6 (six) years old to participate in any Pinelands Adventures Programs. Are all participants at least 6 (six) years old? *
Yes. All participants are at least 6 (six) years old.
I/We are the parents or guardians, and consent to the participation, of the minors listed below in activities related to Pinelands Adventures Services on the conditions set forth above. I attest that the minor is at least 6 (six) years old or older.


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*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Date of Trip: *
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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