Loading...

HIKING TOUR ASSUMPTION OF RISK ANDLIABILITY /WAIVER OF CLAIMS AND INDEMNITY AGREEMENT /DECLARATION OF FITNESS AGREEMENT

Today's Date: July 20, 2019

Please read and be certain you understand the implications of signing.

 

Participant understands signed waiver is valid for any Hiking Tour for our current season.

I Agree

 

Photo Release Agreement

I hereby grant the Keweenaw Adventure Company permission to use my likeness in a photograph, video, or other digital media (photo) in any and all of its publications, including web-based publications, without payment or other consideration. (NOTE: If you do NOT agree please speak with shop representative to confirm your likeness is not used in media, and meanwhlie click "Agree" to proceed and complete waiver.)

I Agree

 

Assumption of Risk associated with Hiking activities:
I do hereby affirm and acknowledge that I have been fully informed of the inherent hazards and risks associated with hiking.

  1. Risk of injury from the activity and equipment utilized is significant, including the potential for permanent disability or death.
  2. Falling, causing broken bones, severe injury to the head, neck and back which may result in severe impairment or even death.
  3. An "act of nature", including but not limited to rock fall, inclement weather, thunder and lightning, severe or varied wind, temperature and other weather conditions.
  4. Risks associated with crossing, climbing or down-climbing rock.
  5. Risks associated with river crossings, fordings or portaging
  6. Possible equipment failure and/or malfunction of my own or others' equipment.
  7. My own negligence and/or the negligence of others, including employees, agents, independent contractors or representatives of Keweenaw Adventure Company, LLC, including but not limited to operator error.
  8. Cold weather and heat-related injuries and illness including but not limited to frostnip, frost bite, hypothermia, heat exhaustion, heat stroke, sunburn and dehydration.
  9. Exposure to outdoor elements, including but not limited to inclement weather, thunder and lighting, severe and/or varied wind, temperature or weather conditions.
  10. Attack by or encounter with insects, animals and/or wildlife. PLEASE NOTE: If paticipant(s) use an INHALER and/or require EPINEPHRINE (EpiPen), they are responsible for bringing their medication for self-administration during the entire tour duration. Keweenaw Adventure Company, LLC DOES NOT provide INHALER or EPINEPHRINE (EpiPen) medications.
  11. Accidents or illness occurring in remote places where there are no available medical facilities and rescue may be distant and time-consuming at best.
  12. Fatigue chill and/or dizziness, which may diminish my/our reaction time and increase the risk of accident.
  13. My sense of balance, physical coordination, and ability to follow instructions.

*I understand the description of these risks is not complete and that unknown or unanticipated risks may result in injury, illness, or death.

 

Release of Liability, Waiver of Claims and Indemnity Agreement:
In consideration for being permitted to participate in hiking activitiesI hereby agree, acknowledge and appreciate that:

  1. I HEREBY RELEASE AND HOLD HARMLESS WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER CAUSED BY NEGLIGENCE OR OTHERWISE, the following named persons or entities, herein referred to as releasees: Keweenaw Adventure Company, LLC
  2. To release the releasees, their officers, directors, employees, representatives, agents and volunteers from liability and responsibility whatsoever and for any claims or causes of action that I, my estate, heirs, survivors, executors, or assigns may have for personal injury, property damage, or wrongful death arising from the above activities whether caused by active or passive negligence of the releases or otherwise. By executing this document, I agree to hold the releases 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 above activities.
  3. By entering into the Agreement, I am not relying on any oral or written representation or statements made by the releasees, other then what is set forth in this Agreement.

This release shall be binding to the fullest extent permitted by law. If any provision of this release is found to be unenforceable, the remaining terms shall be enforceable.

 

Declaration of Fitness Agreement:
Furthermore, I hereby declare that I am physically fit and that I have no physical or mental condition(s) that should preclude me from participating in my chosen activity, that I am not participating against medical advice or treatment and that I have not been diagnosed by a registered doctor as having a terminal illness. I further declare that in the event that I feel ill or unwell, have any physical complaints whatsoever or if an injury is sustained of any kind during the course of hiking activities, I will notify the guide immediately and before moving away from the immediate vicinity.

 

*I HAVE READ THEASSUMPTION OF RISK /RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT/ DECLARATION OF FITNESS AGREEMENT, AND I FULLY UNDERSTAND ITS TERMS, AND UNDERSTAND THAT I HAVE GIVEN UP LEGAL RIGHTS BY SIGNING IT, AND I SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

First Participant's Name

First Name*

Last Name*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
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*
Check to receive our MONTHLY e-newsletter (special features, discounts, events)!
Your Home City:
Your State's Abbreviation:
How did you hear about this adventure?
Select one of the following:*
FOR PARTICIPANTS OF MINORITY AGE: This is to certify that I, as Parent, Guardian or Temporary Guardian with legal responsibility for this participant, do consent and agree not only to his/her release of all Releasees, but also to release and indemnify the Releasees from any and all liabilities incident to his/her involvement in these programs for myself, my heirs, assigns, and next of kin.
Parent or Guardian's Name

First Name*

Last Name*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
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