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AERIAL ADVENTURE PARK WAIVER

AGREEMENT ASSUMING RISK OF INJURY OR DAMAGE

WAIVER AND RELEASE OF CLAIMS AND INDEMNITY AGREEMENT

Today's Date: June 4, 2020

I have made a voluntary request to participate in the Dells Zipline Adventure & Aerial Park activities ("Program").

-OR-

I, the parent or guardian of the Minor made a voluntary request for the above-named child to participate in the Dells Zipline Adventure & Aerial Park activities ("Program").

1.                In consideration of Dells Zipline Adventures & Aerial Park. allowing the Participant to participate in the Program I do hereby agree:

That I am aware that participating in the Program may be physically and emotionally demanding and dangerous and the Participant may be subject to personal injury, death, or damage to the Participant, or to the Participant’s property by participating in any way with the Program and that I freely, voluntarily, and with such knowledge assume the risk of death, personal injury, or property damage arising from or in any way connected with the Program.  The risks associated with participating with the Program include but are not limited to the following:  cuts, scrapes, bruises, fractures, debilitating injuries, fatalities, medical problems due to the challenging and physically demanding nature of the Program including heart problems, pregnant woman may place the mother and unborn children at risk, falls and other unpredictable risks.
2.             That Dells Zipline Adventures & Aerial Park its sureties and insurers, all personnel of  Dells Zipline Adventures & Aerial Park, and each of them, shall not be held responsible or liable for any injury, damage, loss or expense, either to the Participant, or the Participant’s property, incurred while participating in any way with the Program, except if caused by an intentional act or gross negligence of Dells Zipline Adventures & Aerial Park.
3.             FOR THE PARTICIPANT, AND PARTICIPANT’S HEIRS, EXECUTORS, ADMINISTRATORS, AND ASSIGNS, I DO RELEASE, INDEMNIFY, PROTECT AND DEFEND  DELLS ZIPLINE ADVENTURES & AERIAL PARK, AND ALL OFFICERS, OWNERS, EMPLOYEES, SUPERVISORS, VOLUNTEERS, AND OTHERS EMPLOYED OR PROVIDING SERVICE FOR DELLS ZIPLINE ADVENTURES & AERIAL PARK. HARMLESS FROM ALL LIABILITY, OBLIGATIONS, LOSSES, CLAIMS, DEMANDS, DAMAGES, ACTIONS, SUITS, PROCEEDINGS, COSTS, AND EXPENSES, INCLUDING ATTORNEY’S FEES, OF ANY KIND OR NATURE WHATSOEVER, WHETHER SUFFERED, MADE, INSTITUTED, OR ASSERTED BY THE PARTICIPANT OR ON BEHALF OF THE PARTICIPANT, OR BY THE PARTICIPANT’S HEIRS, EXECUTORS, ADMINISTRATORS, AND ASSIGNS, OR BY ANY OTHER ENTITY, PARTY, OR PERSON FOR ANY PERSONAL INJURY TO OR DEATH OF ANY PERSON OR PERSONS OR FOR ANY LOSS, DAMAGE, OR DESTRUCTION OF ANY PROPERTY, ARISING OUT OF, CONNECTED WITH, OR RESULTING DIRECTLY OR INDIRECTLY FROM PARTICIPANT’S PARTICIPATION IN THE PROGRAM AND WHICH ARISES BY REASON OF ANY ACTUAL OR CLAIMS OF NEGLIGENT OR WRONGFUL ACT OR OMISSION OF THE PARTICIPANT THAT OCCURS WHILE PARTICIPATING IN THE PROGRAM.  The foregoing agreement to indemnify shall continue in full force and effect notwithstanding the conclusion of the Participant’s participation in the Program.  AN ADULT SIGNING THIS WAIVER FOR A MINOR IS AGREEING TO INDEMNIFY DELLS ZIPLINE ADVENTURES & AERIAL PARK, ON BEHALF OF THE CHILD PARTICIPANT, EVEN IF THE ADULT MAY NOT BE THE GUARDIAN OR LEGAL GUARDIAN OF THE CHILD PARTICIPANT.
4.              That I understand that  Dells Zipline Adventures & Aerial Park has the right to deny participation and that it is Participant’s responsibility as a participant to follow the safety standards, guidelines, and procedures established by the staff/instructors.  If the Participant does not understand specific instructions from the staff/instructor at any time, I realize it is the responsibility of the Participant to ask for clarity and/or assistance.
5.            I authorize the leader of the activities to secure such medical advice and services as deemed necessary for the Participant’s health and safety and agree to accept financial responsibility.  I give my consent to the instructors or other medical personnel to treat the Participant in a medical situation.
6.             I consent for all purposes to reproduce and use of photographs and video by the Dells Zipline Adventures & Aerial Park for advertising. In giving this consent, I release the Park and its nominees and designees from liability for any violation of any personal and/or proprietary right I may have in connection with reproduction or use.

              If any provision of this waiver shall be deemed unenforceable by a court of competent jurisdiction, the remaining provisions shall remain in full force and effect as if the unenforceable provision does not exist.  I have carefully read this Waiver and Release and fully understand its contents.  I am aware that by signing this Waiver and Release, I am waiving substantive legal rights of the Participant, and knowing this, I sign it of my own free will.  I hereby represent that I have carefully read and understand the contents of this document and sign the same of my own free will.

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*

Confirm Email*
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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*

Relationship*

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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