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Participant Acknowledgment and Assumption of Risks, Release, And Indemnity Agreement

YOU MUST READ THIS DOCUMENT CAREFULLY BEFORE SIGNING AS THIS DOCUMENT AFFECTS YOUR LEGAL RIGHTS.

The participant must sign this Document. If the participant is under 18 years of age (hereafter referred to as “minor” or “child”) a parent or legal guardian (hereafter collectively “parent”) must also sign.

In consideration of the services offered of Austin Zipline, LLC DBA Zip Lost Pines, a Limited Liability Corporation organized and existing under the laws of the State of Texas (referred to in this document as “Zip Lost Pines”) I, the participant identified above, or the parent or legal guardians (either, “Parent”) of the participant if the participant is a minor (under eighteen years of age), for and in consideration of the services of Zip Lost Pines acknowledges and agrees as follows:

Activities and Risks:  

Participating (whether attending, observing or engaging) in the zip line/challenge activities conducted by Zip Lost Pines includes risks. These risks include, but are not limited to: the inherent risks associated with zip line/challenge activities using fabricated structures, stairs, platforms, surfaces, cables, ropes, suspension bridges (a variety of structures including natural pathways over, around, through on which participants may be asked to walk, climb, swing, with or without assistance from Zip Lost Pines staff or other participants) and associated adventure challenge activities on the Zip Lost Pines tour including close personal contact with staff; use of any equipment, facilities or premises; socializing and travel in ATVs, cars or other vehicles (collectively referred to in this Document as “activities”). The parent of a minor shall give permission for their child to participate in all activities and agree to discuss the nature of these activities and risks with their child.

I ACKNOWLEDGE THAT THE INHERENT AND OTHER RISKS, HAZARDS, AND DANGERS (COLLECTIVELY REFERRED TO IN THIS DOCUMENT AS “RISKS”) OF THESE ACTIVITIES CAN CAUSE INJURY, DAMAGE, DEATH, OR OTHER LOSS TO THE PARTICIPANT OR OTHERS.

The following describes some but not all of those risks:

Among the hazards and risks of the activities and use of the premises, vehicles, and equipment used on the zip tour are the following: falls from structures, abrupt and possible harmful contact with structures (fixed and movable), objects, and other persons moving on, around, and over high and low challenge course elements, zip lines, aerial adventure tours and other structures at heights ranging from six inches to fifty feet or more. Including being suspended from cable, possibility of being jolted, jarred, bounced, thrown to and fro and shaken about while on the zip line/challenge activities, loss of balance or grip, slippery or wet equipment and surfaces, entanglement in rope lanyards or harness, impacting the ground, brake or zip line system, equipment failure, displaced safety equipment, anchor attachment failure, general slips/falls/trips, painful crashes while using the landing platforms or rope bridges or any of the activities on the premises at large.  Participants may experience heat stroke, hypothermia, anxiety and other fear responses, elevated heart rates, careless acts by other participants and staff, close personal contact with others including the possibility of inadvertent unwelcome touching, acts of nature related to being in outdoor venues, and other risks that may or may not be anticipated by participants and staff. These risks and others may result in injury, fatigue, psychological stress, and even death. These risks are inherent in Zip Lost Pines zip line tour and in moving about the facilities where these activities are offered -- that is, without such risks the activity would lose its value and appeal. The description of the risks is not complete and other unknown or unanticipated risks may result in property loss, injury or death. Engaging in these activities may require a degree of skill and knowledge different from other activities participants may be familiar with. Participants have the responsibility of managing the risks to themselves and others.

The activities, in addition to being recreational, are educational and instructional in nature and participants are expected to expand their skills and judgment. Management of risks is an important priority in the facilitation of all levels of the activities, however accidents do occur.

Medical Issues:  Zip Lost Pines, zip line activities are designed to be physically and emotionally demanding, for participants of average mobility and strength who are in reasonably good health. Certain medical conditions may increase the inherent risks of the experience and cause participants to be a danger to themselves or others. These potentially dangerous conditions include:  obesity, high blood pressure, cardiac and coronary artery disease, pulmonary problems, pregnancy, arthritis, tendonitis, or other joint and muscular-skeletal problems, seizure disorders, asthma, allergies, diabetes, impaired balance, mobility, eyesight, or hearing, and other physical, psychological and psychiatric problems.  Participants, including Parent if the participant is a minor, must carefully consider these issues before choosing to participate, and fully inform Zip Lost Pines staff of any potentially dangerous condition prior to participating in the program’s activities. By accepting a participant with a disclosed condition, Zip Lost Pines, is NOT representing that it can, or will, successfully manage an event arising out of that condition.  Unless notified otherwise in writing, Zip Lost Pines will assume that the participant is physically and emotionally capable of participating in the activities without being a danger to themselves or others.

RELEASE:  I, AN ADULT PARTICIPANT, OR PARENT IF SIGNING ON BEHALF OF A MINOR PARTICIPANT (IF PARENT, FOR MYSELF AND, TO THE EXTENT ALLOWED BY LAW, ON BEHALF OF THE MINOR), HEREBY AGREE TO RELEASE AND HOLD HARMLESS ZIP LOST PINES, ITS OWNERS, OFFICERS, DIRECTORS, EMPLOYEES, VOLUNTEERS, AGENTS, LESSER, AND LESSORS (THE “RELEASED PARTIES”) WITH RESPECT TO ANY AND ALL CLAIMS, OF WHATEVER NATURE, INCLUDING FOR PROPERTY DAMAGE AND PERSONAL INJURY INCLUDING MEDICAL EXPENSES AND NON-ECONOMIC DAMAGES BE IT FOR MYSELF OR MY CHILD/CHILDREN, EMOTIONAL TRAUMA AND DEATH, WHICH I OR MY MINOR CHILD MIGHT INCUR OR CAUSE WHILE ENROLLED OR PARTICIPATING IN THE ZIP LOST PINES ZIP LINE ACTIVITIES.

INDEMNITY: I, AN ADULT PARTICIPANT, OR PARENT IF SIGNING ON BEHALF OF A MINOR PARTICIPANT (IF PARENT, FOR MYSELF AND, TO THE EXTENT ALLOWED BY LAW, ON BEHALF OF THE MINOR) HEREBY AGREE TO INDEMNIFY (THAT IS, DEFEND AND PAY OR REIMBURSE) CLAIMS OF MEMBERS OF MY, OR THE CHILD’S, FAMILY FOR LOSSES SUFFERED BY ME OR THE CHILD; AND CLAIMS OF THIRD PARTIES, INCLUDING CO-PARTICIPANTS, FOR ANY INJURY OR LOSS CLAIMED TO BE CAUSED IN WHOLE OR PART BY ME OR THE CHILD.

THESE AGREEMENTS OF RELEASE AND INDEMNITY INCLUDE CLAIMS ARISING IN WHOLE OR IN PART FROM THE NEGLIGENCE (BUT NOT THE GROSS NEGLIGENCE) OF A RELEASED PARTY.

Additionally:

In the event of a medical emergency, Zip Lost Pines is authorized to provide or obtain such medical care for the minor child or myself, as it deems necessary, at my expense.

Zip Lost Pines, reserves the right to exclude anyone from participation, for medical, safety, or other reasons it deems appropriate.

Zip Lost Pines, and persons acting for or through it may create and use, reproduce, assign and/or distribute photographs, films, videotapes, and sound recordings of me or my child, for marketing or educational materials and without compensation to me or the child.                             

Any suit arising out of a dispute between me or the child and a Released Party, must be filed and maintained solely in the courts of Travis County, Texas and will be governed by the laws of the State of Texas, not including laws which might invoke the laws of another jurisdiction.

If a provision is found by a court of competent jurisdiction to be unenforceable, the other provisions of the agreement shall remain in full force and effect.

Acknowledgments, Agreements, and Assumption of Risks:

 

I Agree
I acknowledge that by participating I am representing that I am qualified to participate in these activities through my general good health, and proper physical and emotional condition.

 

I Agree
I agree to follow all instructions given to me by the Zip Lost Pines staff while I am on the premises and/or participating in activities.  

 

I Agree
I acknowledge I have been informed of and understand the nature of the program offered by Zip Lost Pines, and its inherent and other risks and that participation is entirely voluntary. I acknowledge and assume ALL the risks of participating in the zip line tour activities whether or not described above, and inherent or otherwise. If I am signing this document as a Parent, I have discussed the activities and their risks with my child who understands and wishes to participate nevertheless.

 

I Agree
I acknowledge that I have been given the opportunity to ask questions regarding any aspect of this agreement, and by signing below I acknowledge that I have read completely and fully understand all aspects of this agreement and agree to its terms. This agreement, including the agreements of release and indemnity, is intended by me to be binding, including on my or the minor child’s estate and heirs, to the fullest extent allowed by law.

 

 

First Participant's Name

First Name*

Last Name*
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*
Participant's 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
Check to receive information, upcoming events, and discounts by e-mail.
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*
How Did You Hear About Us?
Please select how you heard about Zip Lost Pines?*

If other, please describe:
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. [agree]I acknowledge that I am the parent or legal guardian of the minor participant, and I am releasing the claim not a sibling or other relative of the minor.
Parent or Guardian's Name

First Name*

Last Name*
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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