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Liability Release Form

Today's Date: October 17, 2021

(Must be signed and turned in before starting any activities)

In consideration of being allowed to participate in any Beach Woody's LLC and Paddle Board Newport Beach programs and / or related activities, I acknowledge and agree to have read and fully agree to the following disclosures:

  1. Risk of injury from the actives involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist.
  2. I acknowledge that surfing, boogie boarding, and Paddle Boarding may be dangerous and I accept and assume such risk, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, or others, and assume full responsibility for my participation. I am aware that open water activities in general, and surfing, boogie boarding, or Paddle Boarding specifically, involves inherent risks.
  3. I willing agree to RELEASE Beach Woody's LLC, Paddle Board Newport Beach, The State of California, City of Newport Beach, Sub-Contractors of Paddle Board Newport Beach from responsibility and waive all my rights to take any legal action against Beach Woody's LLC, Paddle Board Newport Beach, The State of California, City of Newport Beach, and Sub-Contractors of Paddle Board Newport Beach. If however I observe any unusual significant hazards during my presence or participation I understand that it is my responsibility to remove myself from participating and bring such to attention of the nearest official immediately.
  4. I WAIVE MY RIGHT TO SUE Beach Woody's LLC, Paddle Board Newport Beach, The State of California, City of Newport Beach, and Sub Contractors of Paddle Board Newport Beach. In consideration for Paddle Board Newport Beach agreeing to provide me with surfing or Paddle Board instructions and allowing me to participate in this class, lesson, or rent surf , boogie board, or paddle related equipment, I agree that I shall not make a claim or bring any actions against, sue, or hold responsible, Paddle Board Newport Beach, its owners, officers, agents, employees, associates, representatives, (referred to collectively in this agreement as "Paddle Board Newport Beach") as well as The State of California, City of Newport Beach or expect, require, or pursue them, to be held accountable for any damages. I voluntarily agree to release, discharge, and hold harmless Paddle Board Newport Beach from and against any and all claims of liability, even those arising out of their negligence, fault, recklessness, or any act of omission which causes me damages, illness, injury, disease, or death, of any nature in any way connected with my participation in this activity. I also expressly agree to release and discharge Paddle Board Newport Beach from act or omission, excluding acts of wanton or gross negligence, in rendering or failing to render any type of rescue, emergency, or medical services.
  5. I agree to replace and/or compensate for all or any equipment damaged due to my negligence.
  6. I, for myself and on behalf of my heirs assign, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS, Beach Woody's LLC, and Paddle Board Newport Beach, their officers, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable owners and lessons of premises used to conduct the event("Release"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss, or damages to personal, WETHER ARISINGFROM NEGLIGENCE OF THE RELEASES OR OTHERWISE, to the fullest extent permitted by law.
  7. I hereby grant Beach Woody's LLC and Paddle Board Newport Beach to use my likeness in a photograph or video in any and all of its publications, including website entries, without payment of any other considerations. I understand and agree that these materials will become the property of Paddle Board Newport Beach and will not be returned. I hereby irrevocably authorize Paddle Board Newport Beach to edit, alter, copy, exhibit, publish or distribute Photos or Video taking during my surf or paddle board session for purpose of publicizing Beach Woody's LLC and Paddle Board Newport Beach or for any other lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph or video. I hereby hold harmless and release and forever discharge Beach Woody's LLC and Paddle Board Newport Beach from all claims, demands, and cause of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS. UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
  8. I aggree that Beach Woody's LLC, Paddle Board Newport Beach, The State of California, City of Newport Beach, and Sub Contractors of Paddle Board Newport Beach is not resposible for any personal belongings lost or damanged while renting equipment.

 

Lost, Stolen, or Broken Replacement Fees:

Paddle Boards -$600

Kayak: $600

Paddle - $150

Surfboards - $200

Wetsuits - $100

Boogie Boards - $20

Rash Guards - $20

Life Jacket - $35

Waterproof Cell Phone Case - $15

Waterproof Speaker - $40

GoPro: $225

Beach Crusier: $240

Electric Bike: $2000

Bike Lock: $20

Bike Basket: $20

 

First Participant's Name

First Name*

Last Name*

Phone*
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*

Phone*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

Phone*
Tenth Participant's Date of Birth*
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*
Parent or Guardian's Driver's License / ID Card

Driver's License / ID Card Number*

Issuing State*
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*
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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