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Reston Association & Surf Reston waivers for lake activities involving Stand Up Paddleboarding.

Reston Association Waiver

I hereby assume all risk and agree to accept full responsibility and liability for any damages or bodily injuries I or anyof my dependents may cause, sustain, or suffer arising out of participation in the above-referenced Activity, including any such damages or bodily injuries occurring during, resulting from, or related to any travel to or from the Activity.

I hereby agree to be fully liable for and I hereby agree to waive and release on behalf of myself and my heirs,successors and assigns, the Reston Association, its Board of Directors, officers, employees, agents, volunteers, and membersfrom any and all injuries, bodily injuries, costs, damages, causes of action, claims and any consequential and incidental damagesarising out of or resulting from any injury, death, or damage to property which I or my dependent may sustain, suffer, or cause as a result of my participation in the above-referenced Activity, including any such injuries, costs, damages, causes of action, claims and any consequential and incidental damages occurring during, resulting from, or related to any travel to or from the Activity.

I further agree to indemnify, reimburse, and forever hold harmless the Reston Association, its Board of Directors,officers, employees, agents, volunteers, and members from any and all injuries, bodily injury, costs, damages, causes of action,claims and any consequential and incidental damages, including attorneys fees, arising out of or resulting from any injury,death, or damage to property which I or my dependent may sustain, suffer or cause as a result of participation in this Activity,including any such injuries, costs, damages, causes of action, claims and any consequential and incidental damages occurringduring, resulting from, or related to any travel to or from the Activity.

I am aware of the risks associated with participation in this Activity and hereby accept and assume on behalf of myself or dependent full responsibility for any and all such risks, including, without limitation, the need to check with a physicianbefore engaging in this Activity, including any physical activity associated with this Activity. I understand that participation inthis Activity may involve activities where injury can occur and shall be undertaken at my sole risk and expense. I hereby certifythat I am physically fit and have not been otherwise informed by a physician. I understand that Reston Association does not employ physicians and that its staff cannot and do not diagnose medical problems.

I further represent that I or my dependent currently have and carry health insurance and agree that any claim for medical treatment or other purposes shall be made against such health insurance and that my own or dependents ownpersonal health insurance shall be primary insurance and the primary source of health insurance coverage in the event that I ormy dependent sustain or suffer any bodily injury or medical crisis while participating in this Activity.

I acknowledge that I have read and voluntarily agree to the terms of this Indemnification and Waiver. If any portionof this Indemnification and Waiver shall be held invalid for any reason under the laws of the United States, Virginia, or FairfaxCounty, those parts that are not held invalid shall continue in full force and effect.

In addition, I promise to abide by the rules and regulations adherent to this Activity or event and to exercise care andcaution for my personal safety and that of my fellow participants. I understand that Restons lakes are not managed for water quality and that I will enter the lake at my sole risk. I understand further that Restons pathways may have irregularities and Ihave familiarized myself with these conditions.

Surf Reston Waiver

In consideration of the services of Surf Reston, LLC and Reston Association, its owners, members, officers, directors,agents, employees, volunteers and all other persons or entities acting in any capacity on its behalf (hereinafter Surf Reston, LLC referred to as SR and Reston Association referred to as RA), I hereby agree to release and discharge SR AND RA, on behalf of myself, my spouse, my children, my parents, my heirs, assigns, personal representatives and estate as follows:

  1. I acknowledge outdoor activities, including instruction and travel to such activities, entail known and inherent risks,as well as unknown and unanticipated risks which could result in serious emotional or physical injury, paralysis,death, drowning or damage or loss to myself, third parties and my own or others property. I understand such risks cannot be eliminated without jeopardizing the essential qualities of the activity.Furthermore, SR AND RA staff has difficult jobs to perform. They seek safety but are not infallible. They might not beaware of a participants fitness or abilities. They might misjudge the weather, the elements, terrain, trail, lake or riverroute location. They may give insufficient warnings or instructions, and the equipment being used might malfunction.
  2. I hereby voluntarily release, discharge and agree to indemnify and hold harmless SR AND RA from any and all claims,demands, liability, losses or causes of action which are in any way connected with my participation in this activity or use of SR AND RAs equipment or facilities, including claims related to injury to person or property, disability or death,arising from the negligent act or omission of SR AND RA or otherwise, breach of contract and/or warranty orany other legal theory. This waiver does not apply to claims, demands, losses or liability determined to be the result ofthe gross negligence or willful misconduct of SR AND RA.
  3. Should SR AND RA or anyone acting on its behalf, be required to incur attorneys fees and costs to enforce this agreement, I agree to indemnify them for all such fees and costs. I agree that this document and all other aspects of myrelationship with SR AND RA are governed by the laws of the State of Virginia, and that any legal action resulting frommy participation in this activity shall be brought only in Fairfax County, Virginia. In the event that any portion of thisagreement is deemed invalid or unenforceable, all other portions of this agreement shall remain in full force and effect.
  4. I certify that I have no medical or physical conditions which could interfere with my safety in this activity, or else I amwilling to assume and bear the costs of all risks that may be created, directly or indirectly, by any such condition.
  5. I understand it is required by law to have a U.S. Coastguard approved flotation device (lifejacket) while in and on the water. The undersigned understands that Stand Up Paddle boarding may have inherent risks and SR AND RA is not providing such training in connection with the rental of equipment. The undersigned assumes full responsibilityfor deciding where, when and with whom to float with. The undersigned acknowledges and agrees that the rental equipment provided by SR AND RA is for the sole and exclusive use of the undersigned and may not be used by anyother person.
  6. In signing this document, I fully recognize that if injury, illness, death, loss or damage occurs to me while I amengaged in Stand Up Paddle Boarding, I will have no right to make a claim or file a lawsuit against SR AND RA or its officers, agents or employees, even if they or any of them negligently cause or contribute to my injury, illness, death,loss or damage.I hereby grant SR AND RA the right to take and utilize photographs and video of me participating in these activities for the purpose of sale, promotion and advertising.

I have carefully read this agreement and understand its contents and I agree to be bound by its terms. I am aware this is a waiver and a release of liability and I sign it voluntarily. I also understand that I should not and may notparticipate in this activity if I am under the influence of alcohol or drugs.

I HAVE CAREFULLY READ, CLEARLY UNDERSTAND, AND VOLUNTARILY SIGN THIS WAIVER AND RELEASE

First Paddlers Name

First Name*

Last Name*

Phone*
First Paddlers Date of Birth*
I certify that I am 18 years of age or older
First Paddlers Signature*
Second Paddlers Name

First Name*

Last Name*
Second Paddlers Date of Birth*
Third Paddlers Name

First Name*

Last Name*
Third Paddlers Date of Birth*
Fourth Paddlers Name

First Name*

Last Name*
Fourth Paddlers Date of Birth*
Fifth Paddlers Name

First Name*

Last Name*
Fifth Paddlers Date of Birth*
Sixth Paddlers Name

First Name*

Last Name*
Sixth Paddlers Date of Birth*
Seventh Paddlers Name

First Name*

Last Name*
Seventh Paddlers Date of Birth*
Eighth Paddlers Name

First Name*

Last Name*
Eighth Paddlers Date of Birth*
Ninth Paddlers Name

First Name*

Last Name*
Ninth Paddlers Date of Birth*
Tenth Paddlers Name

First Name*

Last Name*
Tenth Paddlers Date of Birth*
Paddlers 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*

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

Emergency Contact's Name*

Emergency Contact's Phone Number*
Acknowledgement of Waivers
I agree to the Reston Association Waiver*
No
Yes
I agree to the Surf Reston Waiver*
No
Yes
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*
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.


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