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Georgia Conservancy Waiver and Release of Liability

Please read this document carefully. It contains important information about your upcoming Georgia Conservancy Trip
and must be signed by all participants. If the(Participant) is a minor, at least one parent or deemed guardian (parent
and guardian being referred to below as Parent) must also sign, to reflect agreement to these terms and conditions on his or her
own behalf and on behalf of the minor participant.
In consideration of the services of the Georgia Conservancy, I, Participant (adult), for myself and on behalf of a minor Participant for whom I sign below, acknowledge and agree as follows:

I, on behalf of myself, fully understand and acknowledge that activities associated with the Georgia Conservancy's Programs and Events include inherent risk and danger. Such activities include participation in the stewardship trips and corporate projects, caving, paddling, hiking, games/activities, camping, service work, trail restoration, and transportation to and from the event or any other activity organized by the Georgia Conservancy. These activities may result in injury or illness including, but not limited to, bodily injury, disease, strains, fractures, partial and/or total paralysis, death or other ailments.

I understand that at all times over the course of a Georgia Conservancy Trip or Event, I will be responsible for my own health and safety. Risks and dangers may arise from foreseeable or unforeseeable causes including, but not limited to, service work and tool use, volunteer decision making, river conditions, weather, lightning, poor trail terrain, swimming, temperature, food preparation, trail conditions, wildlife encounters, mechanical failures, hazards and/or dangers that are integral to outdoor activities.

By my participation in any of these activities I hereby assume all risks and dangers and all responsibility for any losses and/or damages, whether caused in whole or in part by the negligence or omission of trustee, volunteer, officer, agent or employee of the Georgia Conservancy or by any other person. I also understand that because of the remoteness of some Georgia Conservancy trips medical assistance may not be readily available in case of an emergency.

I agree to release, waive, discharge, hold harmless, defend and indemnify the Georgia Conservancy and its trustees, volunteers, officers, agents or employees from any and all claims, actions or losses for bodily injury, property damage, wrongful death, loss of services or otherwise which may arise out of any activities.

I have read and understand that I am releasing, discharging and waiving any claims or actions that I may have presently or in the future for any negligent act or other conduct or omission by trustees, volunteers, officers, agents or employees of the Georgia Conservancy during the activities associated with the Georgia Conservancy Stewardship Trips Program.

 

Participant and/or Parent authorize the Georgia Conservancy and/or parties designated by the Georgia Conservancy to use photos, videos, recordings,statements and written reports which may include the Participant and/or minor/s, in any manner deemed appropriate by the Georgia Conservancy, foradvertising, display, educational or other use.

I Agree

February 22, 2019

 

Please select who will be participating in the Georgia Conservancy's Stewardship Trips Program
AdultMinor(s)Adult and Minor(s)
1 Minor2 Minors3 Minors4 Minors5 MinorsMore Minors6 Minors7 Minors8 Minors9 Minors10 Minors
Continue
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*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email
A signed copy of this waiver will be sent to the email address you provide.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Stewardship Trips 2017
Which Georgia Conservancy Trip are you participating in? (Please select ONLY 1 trip - if participating in multiple trips throughout the year you will need to fill out a separate waiver for each trip)*
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.
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. Please email bfowler@georgiaconservancy.org requesting would like a paper version.


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